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We estimated that a proposed fixed-dollar threshold of $6,450 combined with the proposed multiplier threshold of 1.75 times the APC payment rate, would allocate 1.0 percent of aggregated total OPPS payments to outlier payments for CY 2026

A few commenters indicated that requiring the median, 10th percentile, and 90th percentile allowed amounts in the MRFs may be misleading for patients who would look at this information as a representation of what they would be expected to pay should they receive that item or service at the hospital

S., Lamas, S

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