Navigating the 2026 ASC Payment Rule: What’s New and How to Adapt

The Centers for Medicare & Medicaid Services (CMS) recently released its proposed 2026 ASC payment rule, bringing significant changes that could directly impact how your ambulatory surgery center (ASC) operates. The ASC reimbursement changes in 2026 cover a lot of ground, from which procedures can now be safely performed in an outpatient setting to updates in payment rates and quality reporting requirements.

In this guide, we’ll break down the most relevant ambulatory surgical center payment updates and explain how the right ASC medical software can help your team adapt to these changes without disrupting workflow.

Stay Ahead of the 2026 ASC Payment Rule Changes

What’s New in the 2026 Proposed Payment Rule for ASCs

Managing an ambulatory surgery center means balancing patient care, staff coordination, and compliance with ever-changing regulations.

The proposed 2026 ASC payment rule introduces updates that could influence everything from procedure eligibility to reimbursement structures and quality reporting requirements. For healthcare administrators, understanding these changes now is essential for planning workflows, optimizing revenue, and ensuring continued high-quality patient care.

Here’s a breakdown of the three most significant CMS updates for 2026:

1. Big Expansion of the ASC Covered Procedures List (ASC-CPL)

One of the most significant updates is the expansion of the ASC Covered Procedures List. CMS is proposing to add 547 new procedures, including:

• 276 procedures added under revised criteria.
  
• 271 procedures transitioning from the Inpatient-Only (IPO) list.

This expansion covers specialties such as cardiovascular, spine, and vascular procedures, meaning that more complex surgeries can now be safely performed in outpatient settings. For ASCs, this is a major opportunity to expand services, attract more patients, and increase revenue — all while maintaining safe, high-quality care.

2. CMS ASC Payment Updates for 2026

CMS is also proposing an average 2.4% update for ASC payments. This combines:

• A 3.2% inflation adjustment based on the hospital market basket.
  
• A 0.8% productivity reduction required by the Affordable Care Act.

The proposed ASC conversion factor would be $56.21, compared with $91.75 for Hospital Outpatient Departments (HOPDs). Updates may vary depending on procedure or specialty, but overall, many procedures could see slightly higher reimbursement rates. For administrators, the 2026 ASC payment rule change highlights the importance of reviewing billing practices and ensuring that your revenue cycle processes accurately reflect these updated payment structures.

3. Changes to the ASC Quality Reporting Program (ASCQR)

Quality reporting is getting simplified to reduce unnecessary administrative burden. CMS is removing some measures, including:

• ASC-20: COVID-19 vaccination coverage among healthcare personnel
  
• ASC-22 & ASC-23: Screening for social drivers of health
  
• ASC-24: Facility commitment to health equity

At the same time, CMS is introducing a new measure focused on patient understanding of recovery instructions. Voluntary reporting would start in 2027, with mandatory reporting in 2029. This is all about making sure patients leave your ASC knowing exactly what to expect during recovery, a win for both patient safety and satisfaction.

Turning Change Into Opportunity

CMS’s ASC payment update for 2026 may seem daunting at first glance, but it’s also a chance to expand services, optimize revenue, and improve patient care. By being proactive, your ASC can:

• Offer more procedures safely in an outpatient setting.
  
• Maximize reimbursement with updated payment factors.
  
• Simplify quality reporting while improving patient outcomes.

Staying Ahead of Regulatory Changes with the Right ASC Software Partner

Regulatory updates don’t have to feel overwhelming. With 1st Providers Choice’s ASC EHR software, your team can turn the 2026 proposed payment rule for ASCs from a challenge into a strategic advantage. Our solution has helped numerous ASC teams manage updates seamlessly, maintain compliance, and run operations efficiently — and your center can achieve the same results.

Let’s take a closer look at how our EHR solutions for surgical centers can make your day-to-day operations easier:

Simplified Documentation

Customizable templates and forms enable your staff to capture every detail accurately. Whether it’s new procedures added to the ASC-CPL or updated quality reporting measures, your documentation will always be precise and reliable.

Seamless Scheduling and Billing

Automated coding and scheduling features help prevent errors and lost revenue. As the ASC-eligible procedures list grows, your team can confidently manage all cases, ensuring smooth billing and accurate reporting.

Quality Reporting Made Easy

Track and report required ASC measures, including the new patient recovery understanding metric, directly from your EHR. This ensures timely submissions and helps maintain compliance without extra hassle.

Operational Efficiency

From inventory management to patient communication, our system streamlines everyday tasks. This means your team can focus on delivering excellent care, knowing your operations are organized and compliant.

With 1st Providers Choice as your partner, the 2026 ASC payment rule changes don’t have to feel overwhelming. You can stay ahead, protect your revenue, and provide the best possible care—confident that your EHR has you covered every step of the way.

Face Regulatory Changes Confidently with Support from 1st Providers Choice

The 2026 proposed payment rule is a significant update for ASCs, bringing expanded procedural opportunities, payment adjustments, and changes to quality reporting. Staying on top of these updates isn’t just about compliance—it directly affects patient care, revenue, and the growth of your center.

CMS is accepting public comments on the proposed rule through September 15, 2025, making now the perfect time to review the updates, plan your next steps, and prepare your team.

With the right tools, staying ahead of these changes becomes much easier. 1st Providers Choice’s ASC EHR software is designed to help your center manage new procedures, streamline billing, simplify quality reporting, and maintain operational efficiency.

Ready to see how it can work for your ASC? Schedule a demo today and discover how our EHR can help your team stay compliant with upcoming changes.

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