Medicare Proposed and Final Rule Updates: FY 2027 IPPS Final Rule and CY 2027 OPPS and MPFS Proposed Rules

The Medicare Rules Round-up Webinar was on Wednesday, August 19, 2026 from 11:00 a.m. – 12:00 p.m. CDT with Director of Government Relations, Molly Ford, and the reimbursement and policy advisors from Nimitt Consulting.

The OPPS and MPFS proposed rules were released on July 7 and July 16, respectively. ASTCT circulated draft comments to CMS in advance of the comment period closing.  Comments can be submitted to CMS via https://www.regulations.gov and are due by August 31 (OPPS) and September 14 (MPFS).

The IPPS final rule was issued on July 31 and goes into effect on October 1, 2026.  A few payment highlights include the following:

• Overall payments were increased by 2.3%
• The base payment for MS-DRG 014 (Allogeneic Stem Cell Transplant) decreased slightly from FY 2026 to $87,109
• The base payment for MS-DRG 018 (CAR-T and Other Immunotherapies) has increased by almost $20,000 to $333,445
• The outlier fixed loss threshold has increased to $49,346 per MS-DRG, up from $40,397

Please consider sharing this webinar information with your network of physicians, administrators, providers, or any other colleagues that may be interested.