CMS released its CY 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule on November 4, 2026, finalizing several significant reimbursement changes effective January 1, 2027. 340B Changes and Expanded Site-Neutral Payments are the headline items.
Key provisions include:
2. Accelerated 340B Remedy Recoupment: The annual OPPS non-drug payment offset increases from 0.5% to 2%, rather than the proposed 3%, to recover $7.8 billion associated with the prior 340B payment policy. CMS now projects completion in 2031 rather than 2029 as proposed.
3. Expanded Site-Neutral Payments: Certain imaging services without contrast, including CT, MRI, ultrasound and X-ray services, furnished in excepted off-campus provider-based departments will be paid at Physician Fee Schedule-equivalent rates. CMS projects approximately $260 million in first-year Medicare Part B expenditure reductions.
4. Payment Updates Reduced: OPPS and ASC payment rates increase 2.3%, compared with 2.4% proposed and 2.6% finalized for CY 2026.
5. Inpatient-Only List Phaseout Continues: CMS removes 637 additional procedures from the inpatient-only list, following 285 removals in CY 2026, continuing its three-year phaseout. CMS also expands the ASC-covered procedures list.
