Ambulatory and office-based surgery: regulatory and accreditation changes
Related IHS services: ACHC Ambulatory Surgery Center Accreditation Consulting
Last checked: . 5 entries.
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· Centers for Medicare & Medicaid Services
Full title: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots (Final rule with comment period; FR Doc. 2026-22739)
Centers for Medicare & Medicaid Services states: “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 2027 based on our continuing experience with these systems.”
Related IHS services: Hospital Price Transparency Compliance Program: 45 CFR Part 180 · EMTALA Compliance Program for Hospitals
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CY 2027 Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Final Rule
· Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services states: “CMS issued a final rule that updates Medicare payment policies and rates for hospital outpatient and ambulatory surgical center (ASC) services under the Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System for CY 2027. This new CMS rule will expand outpatient surgery options, lower out-of-pocket costs for imaging services and 340B drugs, and strengthen oversight of select services.”
Related IHS services: ACHC Acute Care Hospital Accreditation Consulting · ACHC Ambulatory Surgery Center Accreditation Consulting
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Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS)
· Centers for Medicare & Medicaid Services
Full title: Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule (CMS-1850-F)
Centers for Medicare & Medicaid Services states: “Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule (CMS-1850-F) On November 4, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for hospital outpatient and Ambulatory Surgical Center (ASC) services under the Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System for calendar year (CY) 2027.”
Related IHS services: ACHC Acute Care Hospital Accreditation Consulting · ACHC Ambulatory Surgery Center Accreditation Consulting
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Medicare Outpatient Final Rule Expands Surgical Options, Lowers Out-of-Pocket Costs for 340B Drugs
· Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services states: “A new Centers for Medicare & Medicaid Services (CMS) rule will expand outpatient surgery options, lower out-of-pocket costs for imaging services and 340B drugs, and strengthen oversight of select services. The rule also updates 2027 payment rates for hospital outpatient departments and ambulatory surgical centers (ASCs).”
Who it applies to, in the source's words: “This policy already applies to clinic visits and drug administration services at those locations. CMS estimates the change would save beneficiaries and taxpayers a total of $260 million in CY 2027 and over $9 billion from CY 2027 to CY 2036. The rule also continues to phase out the "Inpatient Only" procedure list, which will allow more services to be delivered in outpatient settings, and it also continues to expand the ASC covered procedures list by several hundred surgical procedures. These changes give physicians more flexibility to choose an appropriate care setting and give patients more outpatient surgical options while maintaining patient safety.”
Related IHS services: Patient Safety Organization Formation and Listing Readiness · 340B Program Integrity & Audit Readiness
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October 2026 Update of the Ambulatory Surgical Center (ASC) Payment System
· Centers for Medicare & Medicaid Services
Full title: October 2026 Update of the Ambulatory Surgical Center (ASC) Payment System (Transmittal R13983CP)
CMS issued transmittal R13983CP (Change Request 14634), "October 2026 Update of the Ambulatory Surgical Center (ASC) Payment System", on October 8, 2026, with an implementation date of 2026-10-05.
Related IHS services: ACHC Ambulatory Surgery Center Accreditation Consulting
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