The Centers for Medicare and Medicaid Services (CMS) released its 2026 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule July 15. ACR® prepared a radiology-specific preliminary summary of the proposed rule, which proposes to increase the conversion factor from calendar year 2025 by 2.4%, to $91.747 for 2026.
In addition to payment update policies, CMS seeks feedback within the proposed rule about current Software as a Service (SaaS) policies that determine reimbursement for AI technologies. The agency also requests information from stakeholders regarding potential adjustments to OPPS payments for services predominantly performed in ambulatory surgical centers or physician office settings.
CMS in its press release says this year’s proposed rule will improve access to outpatient care, reduce unnecessary costs, and deliver savings for both the Medicare program and beneficiaries, estimated at nearly $11 billion during the next 10 years. The agency created a 2026 HOPPS PR fact sheet with more information. The final rule will be issued in November.
The College continues to review this proposed rule and will provide a detailed summary in the coming days. If you have questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst.
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