The Centers for Medicare and Medicaid Services (CMS) released the 2026 Inpatient Prospective Payment System (IPPS) final rule on July 31, finalizing a net increase of 2.6% for inpatient hospital payments. This payment update reflects a 3.3% increase in the hospital market basket reduced 0.7% by the productivity adjustment.

The ACC commented on the following provisions, which have now been finalized:

• Percutaneous Coronary Atherectomy: CMS finalized a new Medicare Severity Diagnosis Related Groups (MS-DRG) for percutaneous coronary atherectomy to better align reimbursement with cost.
• Single Valve Procedures With Open Surgical Ablations: CMS did not create new MS-DRGs for cases reporting an open valve procedure and an open surgical ablation procedure and maintains current MS-DRG assignment.
• Drug-Coated Balloon: CMS did not list the new drug-coated balloon procedure as an operating room procedure and maintained its current designation.
• Hospital Inpatient Quality Reporting Program: CMS finalized changes to the Acute Ischemic Stroke Hospitalization with Claims-Based Risk Adjustment for Stroke Severity outcomes measure, including Medicare Advantage patients and shortening the performance period to two years.
• Health Equity and Social Drivers of Health Measures: CMS removed four measures including the Hospital Commitment to Health Equity, COVID-19 Vaccination Coverage among Health Care Personnel and Screening for Social Drivers of Health.
• Transforming Episode Accountability Model (TEAM): In comments to CMS, the ACC proposed adjusting the model to require referral following CABG be made to the treating cardiologist. Instead, the final rule requires a primary care referral, which hospitals do not need to orchestrate should a patient indicate they already have a primary care provider at intake.
• HTI-4 Final Rule: CMS updated the ONC Health Information Technology (IT) Certification Program, focused on standards for electronic prescribing, real-time prescription benefit checks, and electronic prior authorization.

View the ACC's comment letter on the 2026 IPPS proposed rule. For more information, access the full text of the final rule, IPPS Fact Sheet, HTI-4 Blog Post and HTI-4 Fact Sheet.

For more on how ACC Advocacy reviews and responds to agency proposals, access the ACC's Regulatory Affairs Roadmap.

Keywords: Inpatients, Prospective Payment System, ACC Advocacy, Quality Indicators, Health Care, Health Equity