Lexology December 2, 2024
McGuireWoods LLP

On Nov. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will increase payments to end-stage renal disease (ESRD) facilities in calendar year 2025. The ESRD prospective payment system (PPS) final rule also includes updates to the wage index calculations, changes to outlier payments and the definition of outlier services, updates to the list of oral-only drugs and biologics included in the ESRD PPS payment bundle, changes to the low-volume payment adjustment (LVPA) eligibility criteria, coverage for in-home dialysis services for beneficiaries with acute kidney injury (AKI), and modifications to the ESRD quality incentive program (QIP) and ESRD treatment choices (ETC) model.

Pursuant to the ESRD final rule, the 2024 ESRD PPS base rate...

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Topics: CMS, Govt Agencies, Insurance, Payer, Provider
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