The Centers for Medicare & Medicaid Services (CMS) has released its CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule. In addition to proposing a 2.4% payment rate update for both outpatient and ASC services meeting applicable quality reporting requirements, CMS also proposed a number of updates surrounding the inpatient-only (IPO) list, the ASC covered procedures list (CPL), and a new patient-reported outcome performance measure (PRO-PM). Below is a summary of some of the most important proposals; the full proposed rule can be found in the federal register.
The Information Transfer PRO-PM
One of the key proposals in this rule is the inclusion of the Information Transfer PRO-PM into the ASC Quality Reporting (ASCQR) Program, with voluntary reporting in CYs 2027 and 2028 followed by mandatory reporting in 2029. This quality measure captures patient feedback on how well care teams communicated and coordinated information during transitions, focusing on the patient perspective in measuring care quality, and encouraging hospitals to enhance communication during care transitions, especially post discharge.
If finalized as proposed, ASCs will have to administer this one-time 9 question survey between 2-7 days after a procedure. They will also have to submit that data through the Hospital Quality Reporting system, either directly or through a vendor. Force Therapeutics can help your organization seamlessly comply with the Information Transfer PRO-PM by effectively preparing your patients for surgery and recovery through high-quality remote education that keeps patients well informed of their recovery plan throughout the episode of care.
CMS had already introduced the Information Transfer PRO-PM, which is an abbreviation of the Patient Understanding of Key Information Related to Recovery After a Facility-Based Outpatient Procedure or Surgery PRO-PM, into the Hospital Outpatient Quality Reporting (OQR) Program, with voluntary reporting in CY 2026 followed by mandatory reporting in CY 2027. In addition, CMS recently finalized its proposal to include the Information Transfer PRO-PM as a quality measure in the upcoming Transforming Episode Accountability Model (TEAM) for performance years 3-5.
The inclusion of this PRO-PM across several programs showcases how CMS is focused on increasingly incorporating the patient perspective and the importance of communication into measuring quality performance.
Inpatient-Only and ASC Covered Procedures Lists
Beginning in 2026, CMS proposes to eliminate the IPO list over a 3-year period, starting with the removal of 285 primarily musculoskeletal procedures, listed in Table 69 of the proposed rule. If finalized, this proposal would eliminate the IPO list by January 2029. This change would allow these procedures to be performed safely in outpatient settings when clinically appropriate.
Simultaneously, CMS is proposing a revision in the ASC CPL to render five general exclusion criteria as nonbinding physician considerations for patient safety. As a result of this revision, CMS is also proposing to add 276 procedures (shown in Table 80 in the proposed rule) to the ASC CPL; in addition, CMS is proposing the addition of 271 codes (which are proposed for removal from the IPO list in CY 2026, as noted above) to the ASC CPL.
If finalized, these proposals would make a substantial number of procedures possible to perform in the ASC, further accelerating the ongoing shift of surgical procedures away from hospitals and toward ASCs.
Looking Ahead: Site of Service Flexibility and Patient Safety
The CMS CY 2026 OPPS and ASC proposed rule reflects a continued shift toward greater outpatient flexibility, more specific safety expectations, and increased incorporation of patient perspectives into quality measurement.
As CMS amplifies the role of patient-reported outcomes and safety metrics, patient engagement platforms like Force Therapeutics can play a pivotal role in helping your organization streamline PROMs collection, improve patient engagement, and ensure compliance with reporting requirements.
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