The Centers for Medicare and Medicaid Services (CMS) has released the 2026 OPPS proposed rule and fact sheet. The rule is notable for two major changes that will have an impact on interventional cardiology. 

Inpatient Only (IPO) List  

CMS is proposing to phase out the inpatient-only list over a period of three years. The IPO list would be completely eliminated on January 1, 2029. For the first phase in 2026, CMS is proposing to remove 285 procedures for 2026 starting mainly with musculoskeletal procedures. 

To ease the transition, CMS is also proposing to give the removed procedures an exemption from medical review activities, such as compliance with the 2-midnight rule. This exemption would continue indefinitely, until the Secretary deems the procedure is commonly performed in the outpatient setting.  

ASC Covered Services List 

CMS is proposing to revise the general exclusion criteria used to determine eligibility for the covered services list by moving five exclusion criteria to a new section called nonbinding physician considerations for patient safety. One of the criteria proposed to be moved to the new section is the exclusion for procedures that directly involve major blood vessels. CMS states these changes would allow physicians to use their clinical judgment to determine the appropriateness of the ASC setting. 

CMS is also proposing to add 276 procedures to the ASC-covered services list for 2026, in addition to another 271 procedures currently on the IPO list. Of note, these codes include the new percutaneous coronary intervention codes for stenting (92X01) and CTO (92X02). Atherectomy also appears to be included, as the list includes several HCPCS codes, including the combination therapy codes C9602 and C9603. SCAI will continue to seek clarification as 92924 is not on the covered services list. 

CMS is accepting public comments on the proposed rule for 60 days from the final publication date. SCAI will continue to analyze the rule and will provide comments to CMS.