Fair Billing Act

The Fair Billing Act requires healthcare providers with off-campus outpatient departments (such as clinics not on the main hospital campus) to use a separate unique identifier for Medicare billing starting January 1, 2026. Providers must submit an initial certification confirming compliance with federal standards within two years before billing, followed by a required follow-up certification. The federal government will establish a review process - including site visits or audits - to verify adherence to these rules before payments are made for services from these departments. This applies specifically to Medicare billing for off-campus outpatient services.