CMS pitches end-stage renal disease payment rule: 4 things to know 

On June 21, CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023.

Advertisement

Here are four takeaways from the proposed rule: 

1. Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities in 2023 for furnishing renal dialysis services. The proposed 2023 base rate is $264.09, an increase of $6.19 to the current base rate.

2. CMS projects that the updates for 2023 would increase the total payments to all ESRD facilities by 3.1 percent compared with 2022. Hospital-based facilities are expected to see total payments increase by 3.7 percent, and freestanding facilities are projected to see a 3.1 percent bump in total payments. 

3. The rule proposes an increase to the wage index floor, a permanent 5 percent cap on decreases to the wage index and a change to the methodology used to calculate the outlier threshold for adult patients. 

4. In the proposed rule, CMS is requesting information regarding health equity issues and a potential add-on payment adjustment for certain renal dialysis drugs and biological products.

The proposed rule can be downloaded from the Federal Register.

 

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Register to Attend Webinar

Reconsider What’s Possible: Enterprise RCM and the Pro-Fee Practice

Tuesday, July 28
11:00 AM - 12:00 PM CDT

Presenters: Garett Kreitz, Med-MetrixJohn Stefanowicz, Med-MetrixPaul Summers, Nevada Heart & Vascular

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.