On June 27, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment rates and policies and includes requests for information under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2025. This rule also proposes an update to the acute kidney injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2025 and proposes to extend Medicare payment to dialysis in the home setting for beneficiaries with AKI. In addition, the rule provides information on how CMS will operationalize the inclusion of oral-only drugs in the ESRD PPS payment as of January 1, 2025. Furthermore, the rule proposes to update requirements for the ESRD Quality Incentive Program (QIP).

For CY 2025, CMS is proposing to increase the ESRD PPS base rate to $273.20, which would increase total payments to all ESRD facilities, both freestanding and hospital-based, by approximately 2.2%. The CY 2025 ESRD PPS proposed rule also includes a proposed change to the methodology for calculating the ESRD facility wage index, proposed changes to the Low-Volume Payment Adjustment (LVPA) methodology, and several proposed changes to the ESRD outlier policy.

Read the full release here.