Hospital Outpatient Prospective Payment System: January 2026 Update

Related CR Release Date: January 28, 2026 
MLN Matters Number: MM14361
Effective Date: January 1, 2026 
Related Change Request (CR) Number: CR 14361
Implementation Date: January 5, 2026 
Related CR Transmittal Number: R13573CP

CR 14361 tells you about:

  • Coding
  • Device pass-through status
  • Comprehensive ambulatory payment classification (APC)
  • Drugs, biologicals, and pharmaceuticals
  • OPPS Pricer logic

Make sure your billing staff knows about these Hospital Outpatient Prospective Payment System (OPPS) updates, effective January 1, 2026.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)14361.

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