CMS Finalizes 2027 OPPS Rule With 340B, Site-Neutral Changes
CMS released its 2027 Hospital Outpatient Prospective Payment System and ASC final rule on November 4, 2026, with most provisions effective January 1, 2027. The rule finalizes a 2.3% payment update, removes 637 services from the inpatient-only list, expands the ASC covered procedures list, and sets Physician Fee Schedule-equivalent payments for certain non-contrast imaging at off-campus provider-based departments (rural sole community hospitals exempt). It also sets 340B drug payment at ASP minus 28% (instead of the proposed ASP minus 33.4%), with exemptions for rural sole community, children's and PPS-exempt cancer hospitals, and redistributes savings into higher payments for other outpatient services including radiation therapy. Separately, CMS is raising the annual reduction used to recover earlier 340B-related payments from 0.5% to 2%, expecting to complete recovery by 2031, with an exemption for hospitals certified on or after January 2, 2018; new provider-based requirements take effect January 1, 2028.