Data / Federal rules / 2025-13360
Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency
The Centers for Medicare & Medicaid Services published this proposed rule in the Federal Register on July 17, 2025. Comments closed on September 15, 2025.
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What the agency says
This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2026 based on our continuing experience with these systems. We also describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. This proposed rule would also update and refine the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, Overall Hospital Quality Star Rating, and hospitals to make public their standard charge information and enforcement of hospital price transparency. This rule also contains requests for information on measure concepts regarding Well-Being and Nutrition for consideration in future years for all three programs (OQR, REHQR, and ASCQR; expanding the method to control for unnecessary increases in the volume of covered OPD services to on- campus clinic visits; software as a service; and adjusting payment under the OPPS for services predominately performed in the ambulatory surgical center or physician office settings.
Key facts
- Document number
- 2025-13360
- Type
- Proposed rule
- Action
- Proposed rule
- Agency
- Health and Human Services Department; Centers for Medicare & Medicaid Services
- Published
- July 17, 2025
- Comments due
- September 15, 2025
- Dates
- To be assured consideration, comments must be received at one of the addresses provided below, by September 15, 2025.
- Docket
- CMS-1834-P
- Regulation ID (RIN)
- 0938-AV51
- Code of Federal Regulations
- 42 CFR 410; 42 CFR 412; 42 CFR 413; 42 CFR 415; 42 CFR 416; 42 CFR 419; 45 CFR 180
- Topics
- Administrative practice and procedure; Diseases; Health facilities; Health professions; Hospitals; Laboratories; Medicare; Puerto Rico; Reporting and recordkeeping requirements; Rural areas; X-rays
- Significant
- Yes, under Executive Order 12866
- Pages
- 390
Other documents from the Centers for Medicare & Medicaid Services
Everything from the Centers for Medicare & Medicaid Services · Rules on administrative practice and procedure · Rules on diseases · Rules on health facilities · Published in July 2025
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.