On July 2, 2026, CMS released a proposed rule entitled, Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; etc. This proposed rule would update the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for CY 2027. CMS proposes updating OPPS payment rates for hospitals and ASC payment rates for ASCs that meet applicable quality reporting requirements by 2.4 percent. 

Specifically, CMS proposes to expand the method to control unnecessary increases in the volume of outpatient services to include imaging without contrast services furnished in excepted off-campus provider-based departments (PBDs) for CY 2027 by applying a Physician Fee Schedule equivalent payment rate for those services. CMS is also proposing to reduce payments for 340B-acquired drugs; adjust payments for non-drug items and services; maintaining its proposal to eliminate the inpatient only (IPO) list; add a cost-of-living adjustment for payments to hospitals located in Alaska and Hawaii; update payment rates for Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) services furnished in hospital outpatient departments and Community Mental Health Centers (CMHCs); and require prior authorization for eight additional Botulinum Toxin Injection service codes. 

The proposed rule is available here. A fact sheet is available here. A press release is available here. 

Impact on General Dentistry: Provisions in this rule may impact dental providers and oral surgeons who furnish services in hospital outpatient departments or ambulatory surgical centers through updates to OPPS and ASC payment rates, quality reporting requirements, hospital price transparency policies, and other outpatient payment system changes. To the extent that oral procedures are performed in these settings, reimbursement levels and administrative requirements may change.