Patients in Powys who travel to hospitals outside the county for operations may have to wait ten weeks longer for non-emergency treatment.
Under Welsh Government targets, only 5% of patients should spend more than 26 weeks on a waiting list.
In an effort to save £2m this financial year, Powys Teaching Health Board is aiming for some patients to wait the maximum 36 week limit.
It has told its neighbouring NHS trust to say it will only pay for treatment carried out between the 32 and 36 week window.
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