HOPPS Proposed Rule Would Grow Site-Neutral Imaging Payments

ACR^® prepared a preliminary summary of the 2027 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule released by CMS July 2. CMS proposes to increase outpatient hospital payment rates by 2.4% with a conversion factor of $102.004.

The rule includes several imaging-related proposals, including updated Ambulatory Payment Classification assignments for certain imaging services, a new payment framework for Software as a Medical Service (SaMS), and continued separate payment for high-cost diagnostic radiopharmaceuticals using mean unit cost data.

CMS also proposes expanding its site-neutral payment policy by paying physician fee schedule-equivalent rates for imaging without contrast services furnished in excepted off-campus hospital departments. The agency estimates the policy would reduce Medicare Part B spending by approximately $260 million in the first year, including $190 million in part B savings and approximately $70 million in reduced beneficiary premiums. ACR is continuing to review this rule and will generate a detailed summary of major provisions in the coming weeks.

If you have questions or for more information, contact Kimberly Greck, ACR Senior Economic Policy Analyst.