Medicare shifts outpatient payments from doctors to hospitals
H.R. 7666 — SOS: Sustaining Outpatient Services Act · Filed by Adrian Smith (R-NE) · 1 cosponsor · Introduced Feb 24, 2026 · Referred to committee
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What it does
This bill amends Medicare law to allow certain items and services furnished by off-campus outpatient departments of hospitals to be paid under the hospital outpatient prospective payment system (OPPS) rather than the physician fee schedule, but only if the total physician fee-schedule payments for that specialty in the prior year were below $2 million. The effect is to shift payment methodology for lower-volume specialty services from physician-based rates to hospital-based rates, potentially affecting how hospitals and physicians are reimbursed for these services starting in 2027.
Why we flagged it
The bill's operative mechanism is a technical amendment to Medicare payment rules, shifting certain off-campus outpatient services from physician fee-schedule reimbursement to hospital outpatient prospective payment. This is a reimbursement-methodology change, not a new benefit or restriction on access.
What the text implies
- The $2 million threshold creates a cliff effect: specialties just above or below the threshold face sudden payment-methodology changes year-to-year, potentially creating billing instability and administrative burden.
- Off-campus outpatient departments may gain competitive advantage over independent physician practices offering the same services, as they can now access hospital-based payment rates; this may accelerate consolidation of outpatient services into hospital systems.
The full analysis lists 4 implications of this text.
Who stands to gain
hospital systems with off-campus outpatient departments; specialty practices affiliated with hospitals