On July 15, CMS proposed including a 2.6% bump to ASC payments for 2026, as well as other reforms aimed at modernizing payments and expanding healthcare access.
Here are five other things to know about CMS’ new proposals for ASCs in 2026:
1. CMS has adopted a new method to control what it called “unnecessary increases in the volume of the clinic visit service furnished in excepted off-campus provider-based departments.” The new method aims to prevent Medicare and its beneficiaries from paying higher amounts in the excepted off-campus PBD settings than in physician offices for certain services. In 2026, this new method will include drug administration services furnished in excepted off-campus PBDs.
2. CMS will also begin cutting some procedures from the inpatient-only list. This will be phased in over a three-year period, beginning with the removal of 285 procedures, mostly musculoskeletal, from the IPO list.
3. CMS will also continue its policy of exempting certain procedures removed from the IPO list from certain medical review activities related to the two-midnight policy.
4. For 2026, CMS has proposed a revision of the ASC Covered Procedures List to modify the general standard criteria and eliminate five of the general exclusion criteria, moving them into a new section as nonbinding physician considerations for patient safety. This will result in the addition of 276 procedures to the CPL. CMS has also proposed adding an additional 271codes to the ASC CPL that have been proposed for removal from the IPO list in 2026.
5. CMS has also proposed continuing policies that provide additional payments for certain non-opioid pain relief treatments in ASCs until Dec. 31, 2027.
