AHA Coding Clinic® for HCPCS - 2026 Issue 1; In This Issue

Medicare Inpatient Only List Update

With the publication of the Calendar Year (CY) 2026 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule, the Centers for Medicare & Medicaid Services (CMS) has recommitted to phasing out the Inpatient-Only (IPO) List through a structured three-year period. The IPO list historically identified services payable only in the inpatient setting, for Medicare recipients, due to their complexity, invasiveness, recovery needs, or resource intensity. The list functioned as a regulatory restriction for facility billing, limiting where hospitals and ASCs could report certain surgical procedures. As medical practice has evolved, CMS determined that many of...

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