CMS on July 15 issued a new proposal for the 2026 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System rule, as well as other reforms aimed at modernizing payments and expanding healthcare access.
The proposed rule would affect approximately 6,100 ASCs nationwide.
Here are three things to know:
1. Using the hospital market basket update, CMS proposed a 2.4% increase to payment rates for ASCs. This update is based on the proposed IPPS market basket percentage increase of 3.2%, reduced by a 0.8% percentage point productivity adjustment.
2. CMS proposes updating OPPS payment rates for qualifying hospitals by 2.4%. This is also based on the projected hospital market basket percentage increase of 3.2%, reduced by a 0.8% percentage point productivity adjustment.
3. The Ambulatory Surgery Center Association applauded the proposed payment hike in a July 15 news release shared with Becker’s.
“The proposed expansion in surgical procedures that may be performed in ambulatory surgery centers reflects our longstanding belief that the clinical judgment of the medical community is the proper determinant for where patients can receive their care,” ASCA CEO Bill Prentice said. “This approach, if finalized, will allow many more Medicare beneficiaries to receive safe and effective care in surgery centers and lower costs for both patients and the Medicare program.”
