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September 23 2026 CMS Termination of Inpatient Only Codes

September 23 2026 CMS Termination of Inpatient Only Codes

September 23, 2026: Attention All Providers: The Michigan Department of Health and Human Services (MDHHS) is issuing this Provider Alert to inform all Medicaid providers of the gradual elimination of the Medicare inpatient only (IPO) services list announced in the CY 2026 OPPS Final Rule. These codes are presently reimbursable only when performed in an inpatient hospital setting.

MDHHS will follow Medicare’s phase‑out schedule, which began January 1, 2026. The IPO list will be obsolete January 1, 2028. As these codes transition out of the IPO designation, MDHHS closely aligns coverage with Medicare’s policy and reimburse applicable services under the Outpatient Prospective Payment System (OPPS) in accordance with CMS Addendum B. When service coverage/reimbursement methodology differences exist between Medicare and Medicaid, Medicaid fee schedules are utilized. The current Michigan Medicaid fee schedule is available at Information Specific to Different Providers.

Inpatient only services have a Medicare OPPS status indicator (SI) of “C” and are listed in addendum E of each year’s OPPS/ASC final rule located on the CMS Hospital Outpatient Regulations and Notices page.