ESRD PPS: Updates to Policies and Payment Rates

CMS issued a final rule that updates payment policies and rates under the ESRD Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2018. In addition, this rule finalizes updates to the acute kidney injury dialysis payment rate for renal dialysis services, as well as updates to the ESRD Quality Incentive Program for payment years 2019, 2020, and 2021. CMS projects that the updates for Calendar Year (CY) 2018 will increase the total payments to all ESRD facilities by 0.5 percent compared with CY 2017. For hospital-based ESRD facilities, CMS projects an increase in total payments of 0.7 percent, while for freestanding facilities, the projected increase in total payments is 0.5 percent.

The final rule also includes:

  • Update to the ESRD PPS base rate
  • Annual update to the wage index and wage index floor
  • Update to the outlier policy

See the full text of this excerpted CMS Fact Sheet (issued October 27).