News

CMS released an update on its processing of Medicare claims, which were impacted by the government shutdown and recent legislation that extended many healthcare policies that had expired at the end of September. This follows an earlier CMS FAQ discussing the extension of telehealth flexibilities. 

CMS released the 2026 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule, which finalized many of the proposed policies, such as:

• Increasing payment by 2.6% for hospitals and ASCs that meet relevant quality reporting requirements
• Eliminating the inpatient only (IPO) list over a 3-year period, beginning with the removal of mostly musculoskeletal procedures for CY 2026
• Revising the ASC covered procedure list (CPL) criteria, which results in hundreds of new procedures being added to the ASC CPL
• Updating skin substitute reimbursement policies to align with skin substitution categorization consistent with the FDA, and establishing a single payment rate for CY 2026
• Creating stricter price transparency requirements