The Centers for Medicare & Medicaid Services (CMS) has proposed changes to implement new statutory requirements affecting certain off-campus outpatient departments. Providers with affected departments could begin preparing now by reviewing their provider enrollment information and understanding upcoming changes to payment requirements.
Upcoming Changes for Off-Campus Outpatient Departments of a Provider: Section 6225 of the Consolidated Appropriations Act (CAA), 2026, establishes new payment requirements for certain off-campus outpatient departments of a provider beginning January 1, 2028. To continue receiving payment for covered items and services, providers will be required to obtain, and bill under, a separate National Provider Identifier (NPI) for each affected department and submit an initial attestation demonstrating compliance with the provider-based regulations within the prior two years. The law also requires a subsequent attestation within a timeframe specified by the Secretary.
The statute defines off-campus outpatient departments of a provider to mean provider-based departments that are not located on the campus of the provider or are not within of the regulatorily-specified distance from a remote location of a hospital.
What’s Happening:
CMS published proposals for implementing the new legislation in the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems proposed rule, which was published in the Federal Register on July 7, 2026 (91 FR 41734). CMS encourages stakeholders to review the proposed rule and submit comments during the public comment period to help CMS finalize the proposals relating to the implementation process. Note that comments must be submitted by August 31, 2026.