Documents › Agency rules › 2025-20907
Health and Human Services Department, Centers for Medicare & Medicaid Services, Office of the Secretary
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
Published November 25, 2025. Takes effect January 1, 2026. printed at 90 FR 53448. amending 42 CFR 410, 42 CFR 412, 42 CFR 413, 42 CFR 415.
This sets what Medicare pays for care that does not need a hospital stay.
What the Rule Says It Does
This final rule with comment period revises 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. In addition, this final rule with comment period announces the closure of a teaching hospital and the opportunity to apply for available slots, and updates and refines 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, as well as summarizes comments received in response to a request for information on measure concepts regarding Well-Being and Nutrition for consideration in future years for the OQR, REHQR, and ASCQR programs.
This is the rule's own summary, as the Federal Register prints it.
The Orders It Names
- Executive Order 14221: Making America Healthy Again by Empowering Patients With Clear, Accurate, and Actionable Healthcare Pricing Information
- Executive Order 14279: Reforming Accreditation To Strengthen Higher Education
The rule names these orders itself. What it does about them is a reading, and none is recorded here.
- The rule itself
Health and Human Services Department, Centers for Medicare & Medicaid Services, Office of the Secretary, “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,” 90 FR 53448 (November 25, 2025). Effective January 1, 2026.
https://www.federalregister.gov/documents/2025/11/25/2025-20907/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment - This page
“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,” a final rule naming an order indexed here. Read the Mandate, https://readthemandate.org/rules/rule-2025-20907/ (retrieved August 26, 2026).
Cite the document when the claim is about what the document says. Cite this page when the indexing, the wording or the record of what has happened is what is being relied on.
How This Rule Is Quoted
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