Pay the same for a procedure wherever it is performed
What the document says“regulations should advance site neutrality by eliminating the inpatient-only list”
The chapter says Medicare generally pays more for procedures performed as hospital inpatient care and less for the same procedure done as an outpatient, and that payment should be the same whether the service is delivered in a physician's office, a clinic or a hospital. It says this would level the playing field and remove financial disabilities for practitioners competing with hospital systems.
What the document actually says“regulations should advance site neutrality by eliminating the inpatient-only list”
Pay the same wherever care happens. Start by scrapping the inpatient-only list.
The same treatment can cost more in a hospital. Medicare pays more there too. The book says the price should be the same everywhere.
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots
2025-11-25 · 90 FR 53448
The calendar year 2026 outpatient payment rule finalizes phasing out the inpatient only list over three years, beginning with the removal of 285 mostly musculoskeletal services for 2026, and adds 271 of those codes to the ambulatory surgical center covered procedures list. That is the step the passage names. The elimination is phased rather than immediate, and taking a service off the list changes where Medicare will pay for it rather than making the payment the same in a physician's office, a clinic and a hospital, which is the wider site neutrality the proposal asks for.
The 2026 rule phases out the inpatient only list over three years. It drops 285 services in 2026 and adds most to a surgery center list. That is the step the passage names. But the change is phased, and it shifts where Medicare pays rather than making prices match.