CY 2026 OPPS/ASC Final Rule Summary

CMS released the calendar year 2026 final rule for Medicare’s hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system (CMS-1834-FC) on November 21, 2025. Policies in the final rule will generally go into effect on January 1, 2026, unless otherwise specified. The final rule was published on November 25, 2025, in the Federal Register. Public comments will be accepted on the codes listed in Addendum B of the final rule with a Comment Indicator of “NI” or “NP”—codes with either an interim Ambulatory Payment Classification or where CMS has not previously sought comment. The public comment period will end on January 20, 2026. CMS is also accepting applications for available graduate medical education residency positions until February 19, 2026, as explained in section XXII. The final 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 the Rural Emergency Hospital Quality Reporting Program.