The Centers for Medicare & Medicaid Services finalized its 2027 outpatient payment rule this week. It updates how Medicare pays hospital outpatient departments and ambulatory surgery centers. CMS estimates the rule affects about 3,500 hospitals and 6,400 surgery centers.
One change concerns procedures that Medicare has historically treated as inpatient-only. Under the new rule, certain services can be paid in a hospital outpatient setting when clinically appropriate. That gives physicians more discretion over where to perform those procedures. Patients should still confirm the setting and their expected costs with their provider before scheduling.
The CMS fact sheet also describes changes to hospital star ratings that put more emphasis on safety of care. The agency has posted the final rule and supporting materials for hospitals and surgery centers preparing for next year.