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To model hospital outlier payments for the CY 2026 OPPS/ASC proposed rule, we applied the overall CCRs from the April 2025 OPSF after adjustment (using the proposed CCR inflation adjustment factor of 0.970113 to approximate CY 2026 CCRs) to charges on CY 2024 claims that were adjusted (using the proposed charge inflation factor of 1.1118 to approximate CY 2026 charges)

The validated path comes first: sleep hygiene, cognitive behavioral therapy for insomnia (CBT-I), evaluation for an underlying sleep disorder, and established interventions such as melatonin where appropriate

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