In the CY2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) seeks comments on their proposal to require that hospitals include in their Medicare cost reports, beginning January 1, 2026, the median payer-specific charges that they have negotiated with Medicare Advantage organizations, by Medicare Severity-Diagnosis Related Groups. The rule also requests comments on a proposed methodology hospitals would use to calculate the median payer-specific charge. Critical Access Hospitals, Rural Emergency Hospitals, and hospitals operated by an Indian Health Program would not report median payer-specific charges on cost reports because these hospitals are not paid using the inpatient prospective payment system (IPPS).
Comments are due on September 15.