The American College of Radiology (ACR) and the American Society of Nuclear Cardiology (ASNC) have issued preliminary summaries of imaging-specific changes in the proposed 2027 Hospital Outpatient Prospective Payment System (HOPPS) rule.
Released by the Centers for Medicare and Medicaid Services (CMS) on July 2, the proposed rule has a 60-day comment period. The finalized changes will appear in the final rule and are effective January 1, 2027.
Topmost among the proposals is a 2.4% increase in outpatient hospital payment rates for facilities meeting quality reporting requirements, with a conversion factor of $102.004, along with a new payment framework for Software as a Medical Service and updated Ambulatory Payment Classification assignments for other imaging services.
CMS also proposes expanding its site-neutral payment policy by paying physician fee schedule-equivalent rates for imaging without contrast services furnished in excepted off-campus hospital departments. The agency estimates the policy would reduce Medicare Part B spending by approximately $260 million in the first year, including $190 million in Part B savings and approximately $70 million in reduced beneficiary premiums, the ACR noted.
Separately, the ASNC noted that the proposal includes reorganizing code assignments within the nuclear medicine Ambulatory Payment Classifications (APCs) while maintaining the existing four-level APC structure for nuclear cardiology, citing the effects of its 2025 separate-payment policy for radiopharmaceuticals on the remaining nuclear medicine APC codes. The agency also proposes moving PET/CT myocardial perfusion codes 78431 through 78433 out of the New Technology APC and into Nuclear Medicine APC 5594, citing sufficient claims volume.
For diagnostic radiopharmaceuticals paid separately, CMS proposes raising the per-day cost threshold that triggers separate payment from $655 to $665, continuing to use arithmetic mean unit cost as a payment proxy, the ASNC highlighted.
Both organizations said they are continuing to analyze the rule and will publish more detailed summaries in the coming weeks.
