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Dialysis reimbursement to increase under CMS proposed rule

healthcare by healthcare
June 27, 2023
in Health Care
Dialysis reimbursement to increase under CMS proposed rule


The Centers for Medicare and Medicaid Services proposed a payment boost for dialysis providers next year in a draft regulation released Monday.

The agency is proposing to raise the end-stage renal disease Prospective Payment System base rate for dialysis services provided to Medicare beneficiaries by $4.42, or 1.7%, to $269.99. It projects total payments will rise 2.6% for hospital-based end-stage renal disease facilities and 1.6% for freestanding facilities.

The proposed payment bump is smaller than the 3.1% pay increase providers saw this year.

Under the proposed rule, the agency would also update the 2024 acute kidney injury dialysis payment rate for end-stage renal disease facilities to $269.99.

It would increase payment for some new renal dialysis drugs and biological products after the end of the transitional drug add-on payment adjustment period, which aims to help facilities adopt treatments for Medicare beneficiaries.

In addition, the agency seeks to address the costs of providing care to pediatric patients with end-stage renal disease. As it collects more data, the agency is proposing a transitional add-on payment adjustment of 30% of the per-treatment amount for pediatric renal dialysis services over three years, starting in 2024.

The draft regulation includes proposals to require providers to report the amount of time beneficiaries spend receiving in-center hemodialysis treatment and the amount of discarded renal dialysis drugs and biological products from single-use packages.

The agency requests input to shape potential rulemaking regarding the low-volume patient adjustment and a possible payment boost to geographically isolated facilities. It proposes to add a handful of reporting measures over the next few years aimed at assessing facilities’ commitments to health equity and bolstering screening for social drivers of health.

The agency is accepting comments until Aug. 25.



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