Infographic: 2026 OPPS Update: What CFOs Need to Know

A 2.6% OPPS increase arrives with new site-neutral cuts and policy shifts that could offset gains.

CMS has issued its final 2026 rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payments. The rule modestly raises payment rates, but pairs that with multiple policy changes that could erode financial gains for many providers. The net effect will vary significantly across health systems, particularly depending on site of care, service mix, rural vs. urban location, and reliance on historically higher outpatient reimbursements. 

Here’s what it could mean for CFOs:

The 2.6% OPPS bump should be treated as a baseline assumption, but not a windfall. Net gains will vary widely depending on how much of a hospital’s volume is outpatient drug administration, off-campus HOPD, or ASC. For now CFOs should also run scenario analyses that account for: site-neutral reductions; 340B recoupment impact; shifting procedure mix (IPO list elimination); and potential quality-reporting or transparency penalties. For hospitals serving high volumes of Medicare beneficiaries, it may be wise to reevaluate service location strategy. For instance, consider shifting certain services on-campus or to inpatient settings if feasible and clinically appropriate. Finally, invest in revenue-cycle and compliance infrastructure (e.g., price transparency, reporting systems) — failure to comply may erode margins.

Check out this breakdown of the key impacts for CFOs.