2027 Medicare Advantage Final Rule, Rate Released
CMS finalized the 2027 Medicare Advantage and Part D rule, updating benefits, cost sharing, Star Ratings policies, and payment rates for plans.
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 Final Rule, Rate Released
CMS finalized the 2027 Medicare Advantage and Part D rule, updating benefits, cost sharing, Star Ratings policies, and payment rates for plans.
Read morePhysician Groups Warn Visa Delays Could Impact Patient Care
More than 30 medical organizations, including the ACR®️, urged federal officials to address immigration barriers preventing international medical graduates (IMGs) from lawfully entering or remaining in the U.S.
Read moreACR Submits Testimony to Congress
ACR®️ submitted testimony to the U.S. House Committee on Appropriations Labor urging strong federal funding for medical research in federal fiscal year 2027.
Read more