US SB1629

Establishes "site neutral" Medicare payments beginning in 2027, requiring the same payment rate for identical services regardless of whether they are performed in a hospital outpatient department, ambulatory surgical center, or other appropriate setting

Requires the Secretary of Health and Human Services to identify at least 66 ambulatory payment classifications eligible for site neutral payments, with authority to add additional classifications deemed clinically appropriate

Exempts emergency department visits, critical care visits, and trauma care visits from site neutral payment requirements by reclassifying them as Comprehensive APCs with all items and services bundled into a single payment

Directs the Secretary to consider Medicare Payment Advisory Commission (MedPAC) recommendations from its June 2023 report on aligning fee-for-service payment rates across ambulatory settings

Amends the Social Security Act to apply site neutral payment rules to the ambulatory surgical center payment system, hospital outpatient department fee schedule, and physician fee schedule