ACR Highlights Imaging Payment Changes in HOPPS Final Rule

ACR^® released a detailed summary of the 2026 Hospital Outpatient Prospective Payment System (HOPPS) final rule released Nov. 21, by CMS. The final changes take effect Jan. 1.

CMS finalized the update to HOPPS payment rates for hospitals that meet quality reporting requirements by 2.6%, increasing the conversion factor for calendar year 2026 to $91.415. Of note, CMS finalized a higher than proposed Ambulatory Payment Classification (APC) and payment of $381.24 for 3D printing services. Non-cardiac contrast-enhanced ultrasounds (CEUS) also received a higher than proposed APC, increasing the reimbursement to $243.77 for CPT codes 76978 and 76979. These reassignments are effective beginning January 1, 2026.

The APC placements and payments for several Software as a Service (SaaS) codes remain stable for 2026, and CMS thanked stakeholders for the responses to their Request for Information on future rulemaking policies related to reimbursement for AI services under the HOPPS.

CMS also finalized Quality Reporting updates for 2026. CMS will expand digital quality measures, remove several outdated metrics, and add OP-40 (CT radiation safety) as a voluntary measure. Emergency Care Access & Timeliness eCQM will become mandatory in 2028 for OQR and 2029 for REHQR.

If you have questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst.