2027 Medicare Advantage Proposed Rule
CMS proposes 2027 Medicare Advantage and Part D updates, including Star Ratings changes and IRA provisions. Comments are due Jan 26, 2026.
Read moreThe Centers for Medicare and Medicaid Services (CMS) released its 2026 Hospital Outpatient Prospective Payment System (HOPPS) final rule Nov 21. ACR® prepared a radiology-specific preliminary summary of the rule, which includes an increase to the conversion factor (CF) from 2025 of 2.6%, bringing it up to $91.415 for 2026.
Among the finalized Ambulatory Payment Classifications (APC) placements, CMS took ACR’s comments into consideration regarding Current Procedural Terminology (CPT®) code 0559T for Anatomic model 3D printed and modified its proposal in the 2026 HOPPS proposed rule, increasing the APC from 5733 (Level 3 Minor Procedures) with payment of $ 60.27, to APC 5734 (Level 4 Minor Procedures) with payment of $135.93 for 2026.
CMS in its press release says this year’s final rule includes policies to increase hospital price transparency key goals of the Trump administration, including requirements for hospitals to post real, consumer-usable prices, not estimates. The agency also created a 2026 HOPPS final rule fact sheet. These final changes will take effect Jan 1.
The College continues to review this final rule and will provide a detailed summary in the coming days.
If you have questions, contact Christina Berry, ACR Team Lead, Economic Policy.
2027 Medicare Advantage Proposed Rule
CMS proposes 2027 Medicare Advantage and Part D updates, including Star Ratings changes and IRA provisions. Comments are due Jan 26, 2026.
Read more2025 MIPS Deadline Reminders and ACR QCDR 2026 Updates
Read this article to learn how and when to submit data to CMS for the 2025 MIPS using the ACR NRDR QCDR and receive updates on what to expect for 2026.
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Supporting radiology clinician-scientists is essential for innovation — a strategic investment that can transform patient care and the future of academic medicine.
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