CMS on June 24 proposed a 1.1% payment increase for dialysis providers in 2027 as part of its annual update to the End-Stage Renal Disease Prospective Payment System.
Six things to know:
1. CMS proposed increasing the base rate to $299.55 per treatment in 2027, up from $281.71 in 2026. The agency estimates the proposal would increase total Medicare payments to dialysis facilities by approximately 1.1%, with payments rising about 2% for hospital-based facilities and 1.1% for freestanding facilities.
2. Medicare is expected to pay about $6.2 billion to roughly 7,600 ESRD facilities in 2027 under the proposed payment system.
3. CMS proposed permanently adding $15.96 to the base payment rate to incorporate phosphate binders into the bundled payment. The agency began incorporating the drugs into the payment bundle in 2025.
4. The proposed rule would expand the low-volume payment adjustment by increasing the treatment threshold from 4,000 to 8,000 annual treatments and creating six payment tiers instead of two. CMS said the change would better align payments with costs at smaller dialysis facilities.
5. CMS also proposed increasing the home and self-dialysis training add-on payment from $95.60 to $138.22 and allowing providers to receive the payment during the first four months of dialysis treatment.
6. The agency proposed several changes to the ESRD Quality Incentive Program beginning in 2029, including replacing the Hypercalcemia reporting measure with a Hyperphosphatemia clinical measure and removing the Medication Reconciliation and COVID-19 Vaccination Coverage Among Healthcare Personnel reporting measures.
Click here to access the 253-page proposed rule.
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