Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating, etc.
Summary
This regulation updates how Medicare pays hospitals and surgical centers for outpatient procedures and how the government measures and publicly reports hospital quality. The changes affect how much money these facilities receive for services and what information patients can see about hospital performance.
Key Points
- 1Medicare is adjusting payment rates to hospitals and ambulatory surgical centers for procedures done on an outpatient basis (patients go home same day)
- 2The rule updates quality reporting requirements, meaning hospitals must collect and submit more detailed data about patient outcomes and care quality
- 3Hospitals will receive updated star ratings that are publicly displayed so patients can compare hospital quality and safety records
- 4The changes take effect for billing and quality reporting in the coming year, affecting thousands of hospitals and surgical facilities nationwide
- 5The public has until January 21, 2026 to submit comments on this rule before it becomes final
Impact Assessment
If you are a hospital or surgical center, this means your Medicare reimbursement rates for outpatient procedures will change and you must comply with updated quality reporting requirements; if you are a patient, this means you'll have access to more detailed public information about hospital quality performance.
National
Significant
Key Dates
November 25, 2025
Regulatory Connections
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.
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
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.
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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