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  • Hospital Outpatient PPS | CMS
    CMS issued the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule that proposes updates to Medicare payment policies and rates for hospital outpatient and ASC services A summary of final provisions is available here
  • Addendum E. -- HCPCS Codes That Would Be Paid Only as Inpatient . . .
    Addendum E -- HCPCS Codes That Would Be Paid Only as npatient Procedures or CY 2026 CPT® is copyright 2025 American Medical Association All Rights Reserved The CPT® data provided in thi list is only approved licensed for use for the approved KnowledgeSource user only Any othe
  • Medicare Program: Hospital Outpatient Prospective Payment and . . .
    This final rule with comment period revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2026 based on our continuing experience with these systems
  • CMS Releases CY 2026 Hospital OPPS and Ambulatory Surgical Center Final . . .
    CMS will maintain the current OPPS payment pathways for SaaS products in CY 2026 but indicated that the issue remains a high-priority area for future policy development
  • Medicare Program: 2026 Hospital Outpatient Prospective Payment and . . .
    The proposed and final status indicators, APC assignments, and payment rates for each HCPCS code can be found in Addendum B to the final rule The complete list of status indicators and definitions used under the OPPS can be found in Addendum D1 to the final rule, while the complete list of final comment indicators and definitions can be found
  • Inpatient-only Services - Novitas Solutions
    There is no payment under OPPS for services that CMS designates to be “inpatient-only” services Inpatient-only services have an OPPS status indicator (SI) of “C” and listed in addendum E of each year’s OPPS ASC final rule located on the CMS Hospital Outpatient Regulations and Notices page
  • CMS OPPS CY2026 Final Rule Summary and Payment Rates
    On November 21, 2025, the Centers for Medicare Medicaid Services (CMS) released a final rule updating Medicare payment rates and policies under the hospital outpatient prospective payment system (OPPS) and the ambulatory surgical center payment system for calendar year (CY) 2026
  • Final CY 2026 Hospital Outpatient and ASC PPS Update Released
    CMS is also finalizing its proposal without modification that the 5 0 percent cap that will apply to the CY 2026 OPPS wage index and will be based off the IPPS wage index for FY 2025 rather than the OPPS wage index for CY 2025
  • CMS releases CY 2026 OPPS-ASC final rule - McDermott+
    Read our key takeaways from the CY 2026 OPPS and ASC final rule, and access our updated interactive dashboard
  • Quarterly Addenda Updates | CMS
    Download OPPS quarterly addenda files with updated payment rates, status indicators, and APC assignments for Medicare hospital outpatient services





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