CMS finalized its 2027 hospital outpatient payment rule on November 4. Imaging without contrast, which covers CT, MRI, x-ray and bone density scans, will pay the same in a hospital outpatient department as in a physician office or an ASC. CMS puts the saving to taxpayers and beneficiaries at more than $9 billion over a decade.
Hospital outpatient departments and ASCs get a 2.3 percent payment increase, trimmed from the 2.4 percent proposed in July. CMS will also take 637 services off the inpatient-only list in 2027, among them endocrine, digestive, auditory and respiratory procedures. The agency has described a three year phase-out of the list.
Medicare will pay 340B participants a drug's average sales price minus 28 percent, which CMS estimates cuts drug spending by about $5.5 billion in 2027. The cut is budget neutral, so non-drug outpatient payments rise by the same total. The final rate is slightly less severe than what CMS proposed earlier in the year.
The inpatient-only list is the piece device companies should read first. A procedure that moves to the outpatient list opens up ASC volume, and ASC purchasing asks a different set of questions about capital cost than a hospital service line does.