CY 2026 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates. CMS-1834-P Display.
Summary
This regulation sets new payment rates that Medicare will pay hospitals and surgical centers for outpatient procedures in 2026. The changes affect how much money these healthcare facilities receive for treating patients, which can influence costs and access to care.
Key Points
- 1Medicare is updating how much it pays hospitals and ambulatory surgical centers (smaller facilities that do same-day surgeries) for services provided to Medicare patients in 2026
- 2The new payment rates will affect thousands of hospitals and surgical centers across the country that treat Medicare patients
- 3These payment changes may influence how much patients pay out-of-pocket and which procedures are available at different facilities
- 4Healthcare facilities and the public have until November 26, 2025 to submit comments on the proposed changes before they become final
- 5The regulation covers a wide range of outpatient services including diagnostic tests, surgical procedures, and other treatments provided without hospital admission
Impact Assessment
If you are a hospital or surgical center, your Medicare reimbursement rates for outpatient procedures will change in 2026, affecting your operating budgets and staffing decisions; if you are a Medicare patient, your out-of-pocket costs and access to outpatient procedures may be affected depending on how facilities respond to new payment rates.
National
Moderate
Key Dates
November 21, 2025
Regulatory Connections
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating, etc.
Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency CMS-1834-P
This summary is for informational purposes only. It may not capture all nuances of the regulation. Always refer to the official text for authoritative information.
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