This bill proposes to amend Medicare payment rules for specific items and services provided at off-campus hospital outpatient departments, allowing them to be reimbursed under the hospital outpatient prospective payment system (OPPS). This change aims to standardize payment for particular services across different outpatient settings, rather than other payment methodologies. Beginning in 2027, this provision will apply to items or services where the total amount paid under the physician fee schedule for a specific physician specialty in the previous year was less than $2,000,000 . The legislation intends to modify the reimbursement structure for these particular lower-volume services. This adjustment could potentially affect the financial operations and sustainability of certain off-campus outpatient facilities by altering their Medicare revenue.