In 2017, CMS implemented a site-neutral payment provision to reduce payment discrepancies between services performed at hospital outpatient departments (HOPDs) and provider-based sites, e.g. physician offices and freestanding clinics. The policy mandates that newer off-campus HOPDs receive reimbursement at a site-specific Medicare Physician Fee Schedule (MPFS) rate. Currently, this rate equals 40% of the hospital rate.