Medicare raises outpatient and surgery center pay 2.3% and cuts pay for 340B drugs
Medicare raises payment rates by 2.3 percent for hospital outpatient departments and for surgery centers that meet quality reporting rules. It cuts pay for drugs hospitals buy at 340B discounts to average sales price minus 28 percent, from plus 6 percent, except at rural sole community, children's and cancer hospitals.
Who it affects
Hospital outpatient departments, ambulatory surgery centers and Medicare patients
When
This rule takes effect on January 1, 2027.
- : Published in the Federal Register
- : This rule takes effect: new outpatient and surgery center payment rates begin
- : Botox injections at hospital outpatient departments need prior authorization
- : Off-campus departments need their own provider number and attestation for payment
Official text
FR Doc. 2026-22739: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots
On Federal Register. The official text is what counts; read it before you act.
Not legal advice. Plain-English summaries to help you find what changes and when. Not legal advice: read the official text, and ask a lawyer about your situation.