End Stage Renal Disease (ESRD) Center
CMS issued a final rule that would update Medicare policies and payment rates for End-Stage Renal Disease (ESRD) facilities on or after January 1, 2015. Several provisions of the Protecting Access to Medicare Act of 2014 (PAMA) apply to the ESRD PPS. The most significant provisions are the elimination of the drug utilization adjustment transition, a 0.0 percent update to the ESRD PPS base rate, and a delay in the inclusion of oral-only drugs used for the treatment of ESRD into the bundled payment until January 1, 2024. For CY 2015, CMS finalized an ESRD PPS base rate of $239.43. This amount reflects the 0.0 percent update to the payment rate required by PAMA and the application of the wage index budget-neutrality adjustment factor.
The rule (CMS-1614-F) can be viewed on the http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/End-Stage-Renal-Disease-ESRD-Payment-Regulations-and-Notices.html web page.
- 7. ESRD Facility Conditions for Coverage [PDF, 1MB]
- FAQs ESRD Rollout FINAL 082808 [PDF, 52KB]
- FY 2016 Preview Period Extended until 8/31 2015 [PDF, 46KB]
- ESRD Prospective Payment System (PPS) Overview
- Report to Congress: A Design for a Bundled ESRD PPS [PDF, 577KB]
- HIPAA - General Information
- Medicare Part B Drug Average Sales Price