2026 ASC payment update
On November 21, 2025, the Centers for Medicare & Medicaid Services (CMS) finalized a 2.6% payment increase for ambulatory surgical centers (ASCs) in 2026, which is higher than the initially proposed 2.4%. This final increase is based on a hospital market basket percentage of 3.3%, reduced by a productivity adjustment of 0.7 percentage points.
Enacted under the Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Final Rule, this update reflects CMS’s recognition of rising operational costs and the continued growth of outpatient surgical services.
Shift toward site-neutrality payments
The rule also finalizes proposals that move Medicare closer to site-neutral payments. Under the rule, CMS finalized a plan to apply the physician fee schedule rates to any code assigned to the drug administration ambulatory payment classification when the services are provided at an off-campus facility.
This adjustment narrows the difference between what Medicare pays in hospital outpatient centers compared to other medical sites.
Elimination of the IPO list
CMS also finalized a plan to phase out the inpatient-only (IPO) list over the next three years, starting with the elimination of 285 codes for 2026. This will allow those procedures to be billed in outpatient settings, including ASCs. The IPO list will be removed entirely by January 1, 2028.
This transition increases the scope of procedures that may be safely performed in lower-cost outpatient settings.
How IMO Health supports these changes
IMO Health’s OR efficiency solution provides clients with not only the IPO list of code coverage and identification but also the ASC-inclusive codes and identification. This allows clients to schedule, prior authorize, and track the revenue of those procedures.
IMO Health manages the maintenance of these codes and the quarterly releases by CMS. This allows clients to be confident that they have the most up-to-date coverage.
Continuously updated clinical terminology ensures every step of the perioperative workflow is compliant with the latest CMS rules. This helps prevent errors that could lead to delays, denials, or rescheduled cases. By keeping teams aligned with current coverage requirements and other regulations, organizations avoid workflow disruptions and maintain strong, predictable revenue integrity.
