On April 11, 2025, the Centers for Medicare and Medicaid Services (CMS) released the FY 2026 Inpatient Prospective Payment System (IPPS) proposed rule. The proposal provides a 2.4% payment update for general acute care hospitals that meet certain quality reporting and electronic health record use standards. While radiation oncology reimbursement typically falls under the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS), the IPPS proposed rule often signals important policy shifts that may also appear in the MPFS or HOPPS this summer.

Items of interest in the 2026 IPPS proposed rule include:

• New Technology Add-On Payments (NTAP) for New Services and Technologies 
• Proposed Changes to Specific MS-DRG Classifications 
• Proposed Discontinuation of the Low-Wage Hospital Policy 
• End of Medicare-Dependent, Small Rural Hospital Designation 
• Proposed Changes to the PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program 
• Proposed Update to the IPPS Labor-Related Share 
• Hospital Readmission Reduction Program 
• Hospital Inpatient Quality Reporting (IQR) Program 
• Medicare Promoting Interoperability Program 

Read ASTRO’s detailed summary of the proposed rule for more information.