ESRD PC Pricer
Section 1881 (b)(12) of the Social Security Act, as amended by section 623 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, establishes the End Stage Renal Disease (ESRD) composite rate payment method for most dialysis related services provided by renal dialysis facilities to Medicare beneficiaries with end stage renal disease.
This PC Pricer software allows users to enter information to predict reimbursement to a renal dialysis facility based on the type of dialysis and various patient characteristics. It contains the same payment logic used to calculate composite rate payments for type of bill 72x in the Medicare mainframe system.
CY 2008 Physician Fee Schedule (PFS) Final Rule with Comment
CMS-1385-FC (Final Rule and Associated Data Files) -- (On Display November 1, 2007; Published November 27, 2007) – See Provisions Related to Payment for Renal Dialysis Services Furnished By End-Stage Renal Disease (ESRD) Facilities {Current CY 2008 wage index data are on page 66284 of the 11/27/2007 Federal Register notice}
CY 2009 Physician Fee Schedule (PFS) Final Rule with Comment
CMS-1403-FC (Final Rule and Associated Data Files) -- (On Display October 30, 2008; Published November 19, 2008) – See Provisions Related to Payment for Renal Dialysis Services Furnished By End-Stage Renal Disease (ESRD) Facilities {Current CY 2009 wage index data are on page 70163 of the 11/19/2008 Federal Register notice}
See Core-Based Statistical Area (CBSA) Information below. This PC Pricer may be downloaded to a hard drive or network drive.
Note: Printing from this PC Pricer requires the use of a post-script driver.
The CMS CY 2018 End Stage Renal Disease Prospective Payment System PC PRICER is now available
User Guide
2019
- CY 2019.1 ESRD Main Frame Pricing Programs – Posted 04/17/2019 (ZIP)
- CY 2019 ESRD PC Pricer – Posted 04/22/2019 - Opens in a new window
2018
- CY 2018.0 ESRD Main Frame Pricing Programs – Posted 03/09/2018 (ZIP)
- CY 2018 ESRD PC Pricer – Posted 01/19/2018 (ZIP)
- CY 2018 ESRD PC Pricer with new runtime – Posted 06/18/2018 - Opens in a new window
2017
- CY 2017.1 ESRD Main Frame Pricing Programs – Posted 07/20/2017 (ZIP)
- CY 2017.1 ESRD PC Pricer – Posted 12/18/2017 (ZIP)
- CY 2017 ESRD PC Pricer – Posted 01/10/2017 (ZIP)
- CY 2017.0 ESRD Main Frame Pricing Programs – Posted 01/04/2017 (ZIP)
2016
- CY 2016.0 ESRD Main Frame Pricing Programs – Posted 01/06/2016 (ZIP)
- CY 2016 ESRD PC Pricer – Posted 05/19/2016 (ZIP)
2015
- CY 2015 ESRD Main Frame Pricing Programs – Posted 02/06/2015 (ZIP)
- CY 2015 ESRD PC Pricer – Posted 09/03/2015 (ZIP)
2014
- CY 2014 ESRD Main Frame Pricing Programs – Posted 01/13/2014 (ZIP)
- CY 2014 ESRD PC Pricer – Posted 05/30/2014 (ZIP)
2013
- CY 2013 ESRD Main Frame Pricing Programs - Posted 12/14/2012 (ZIP)
- CY 2013 ESRD PC Pricer (Updated 05/09/2014) (ZIP)
2012
- CY 2012 Main Frame Pricer Software - Posted 03/13/2012 (ZIP)
- 2012 ESRD PC Pricer (updated 5/29/2012) (ZIP)
- 2012 ESRD PC Pricer User Guide (PDF)