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Technical Specifications

If something isnt working or if a concern arises the protocol changes

Replacing the Estimated Allowed Amount With the Median Allowed Amount and Adding the 10th and the 90th Percentile Allowed Amounts In the CY 2026 OPPS/ASC proposed rule (90 FR 33476), we proposed to revise 180.50(b)(2)(ii)(C) to require, at new 180.50(b)(2)(ii)(C)( 2 ), that, beginning January 1, 2026, if a payer-specific negotiated charge is based on a percentage or algorithm, the hospital must calculate and encode the median allowed amount in dollars for that item or service

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Adding paragraph (b)(7)

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