SOS: Sustaining Outpatient Services Act
Sponsored By: Senator John Hoeven
Introduced
Summary
This bill would expand Medicare's Hospital Outpatient Department payment rules to cover certain low-volume services provided at off-campus outpatient departments. It uses a specialty-level, prior-year payment threshold to decide which services move from the physician fee schedule into the Hospital Outpatient Department Prospective Payment System (OPPS) starting in 2027.
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- Hospitals and off-campus outpatient departments: Would have more items and services paid under the OPPS rather than the physician fee schedule when those services come from specialties whose prior-year physician payments were under $2.0 million. This change kicks in for years beginning with 2027.
- Physicians and specialty practices: Certain low-volume services that a specialty billed under the physician fee schedule could instead be paid at OPPS rates for services furnished at an off-campus outpatient department, based on the specialty's prior-year totals.
- Medicare payment rules: The bill relies on the existing OPPS and physician fee schedule frameworks to set rates and determinations instead of creating new funding streams or separate payment programs.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Medicare change for off-campus services
If enacted, this bill would change how Medicare pays some off‑campus outpatient services starting in 2027. Those services would be paid under the hospital outpatient payment system rather than the physician fee schedule. That payment routing would apply when the prior year’s largest physician-fee-schedule payments for that specialty were under $2,000,000. This change would alter Medicare payments and your cost-sharing, and whether you pay more or less would depend on how hospital outpatient rates compare with physician fee schedule rates.
Sponsors & CoSponsors
Sponsor
John Hoeven
ND • R
Cosponsors
Amy Klobuchar
MN • D
Sponsored 2/25/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov