CY 2026 OPPS/ASC Proposed Rule Summary

CMS released the calendar year 2026 proposed rule for Medicare’s hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system (CMS-1834-P) on July 15, 2025. Policies in the proposed rule will generally go into effect on January 1, 2026, unless otherwise specified. The proposed rule was published on July 17, 2025, in the Federal Register. The public comment period will close on September 15, 2025. The proposed rule updates OPPS payment policies that apply to outpatient services provided to Medicare beneficiaries by general acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term acute care hospitals, children’s hospitals, and cancer hospitals, as well as for partial hospitalization services in community mental health centers. Also included is the annual update to the ASC payment system and updates and refinements to the requirements for the Hospital Outpatient Quality Reporting Program, the ASC Quality Reporting Program and Rural Emergency Hospital Quality Reporting Program.