The 2026 OPPS proposed rule offers a modest 2.4% payment update, along with some major policy shifts. CMS is pushing for an expansion of site-neutral cuts, tougher price transparency enforcement, and an accelerated 340B "clawback," and elimiation of the inpatient only list.
The Centers for Medicare & Medicaid Services (CMS) has released its 2026 Hospital Outpatient Prospective Payment System (OPPS) proposed rule, which includes a 2.4% payment update for hospitals and ambulatory surgical centers (ASCs).
The rule also proposes a significant expansion of site-neutral payment policies, tougher enforcement for price transparency, and a controversial payment reduction related to the 340B program.
Check out the infographic below for more information, or read the full story here.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
CMS continues its push for site-neutral payments by proposing to expand cuts to include drug administration services and to phase out the Inpatient Only list over three years.
The proposed rule requires more specific negotiated rate disclosures and aims to ramp up price transparency enforcement.
The rule proposes to accelerate the 340B recoupment by quadrupling the downward payment offset for non-drug services from 0.5% to 2%, a "clawback" policy the AHA deems unlawful.