Issued2026-07-07

Medicare CY 2027 OPPS/ASC Proposed Rule: Software as a Medical Service (SaMS)

Proposed RuleSector

Summary

Proposes Medicare outpatient payment treatment for software as a medical service, including a separate OPPS payment indicator for qualifying algorithmic clinical software and treatment of related HCPCS codes.

Healthcare Implications

If finalized, could change outpatient reimbursement for qualifying algorithmic medical software and purchasing incentives for hospitals and developers; the proposal is not current payment policy.

Impact Level

Medium

Keywords

Clinical Quality & Efficacy; Transparency & Governance

Stakeholders

Providers & Health Systems; Payers & Purchasers; Developers & Vendors; Regulators & Government