The 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.
ACR Releases Summary of MedPAC March Report
Highlighting MedPACās March findings on Medicare spending, payment adequacy, and key recommendations for physicians and hospitals.
Read moreState AI Healthcare Bills Draw ACR Attention
State legislatures are advancing AI healthcare bills targeting insurer denials, clinical guardrails, and transparency for AI use in care and coverage.
Read moreACR Backs Fix to Burdensome Noridian TPE Reviews
ACR urges Noridian to end prepayment reviews of radiologistsā professional components, citing access barriers and high denial rates.
Read more