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  • Calendar Year 2025 End-Stage Renal Disease (ESRD) Prospective Payment . . .
    On November 1, 2024, the Centers for Medicare Medicaid Services (CMS) issued a final rule updating payment rates and policies 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 finalizes an update to the acute kidney injury (AKI) dialysis payment rate for renal
  • OUTPATIENT DIALYSIS SERVICES PAYMENT SYSTEM
    Beginning in 1983, Medicare paid dialysis facilities a predetermined rate (the composite rate) intended to cover a specific bundle of services provided to patients in a given dialysis treatment To improve provider efficiency, Medicare implemented a modernized prospective payment system (PPS) for outpatient dialysis services in 2011
  • 2025 ESRD Dialysis Rule - bgrdc. com
    2025 ESRD Dialysis Rule CMS has issued a final rule updating Medicare payment policies for dialysis and care for people with End-Stage Renal Disease (ESRD) for 2025 CMS estimates the policies will result in a 2 7% increase in payments in 2025, up from 2 2% in the proposed rule
  • How Regulatory Failures Have Crippled Dialysis Care - April 9, 2025 . . .
    The current dialysis market is highly concentrated, with two large corporations, DaVita and Fresenius, owning 75 percent of the dialysis market, and more than 25 percent of patients with ESRD living in counties where all facilities are owned by one or two corporations
  • End Stage Renal Disease (ESRD) Prospective Payment System (PPS)
    Under the ESRD PPS, the beneficiary co­-insurance amount is 20 percent of the Medicare-approved amount for each dialysis treatment given in a dialysis facility or at home (including any applicable adjustment, outlier or add on amount), after the deductible
  • INDIVIDUAL AND SMALL GROUP MARKET RISK ADJUSTMENT TRANSFERS
    In the 2024 benefit year, risk scores decreased nationally by approximately 0 22 percent in the individual non-catastrophic market risk pool and increased by 2 30 percent in the small group market risk pool when compared to the 2023 benefit year risk scores
  • Calendar Year 2024 End-Stage Renal Disease (ESRD) Prospective Payment . . .
    On October 27, 2023, the Centers for Medicare Medicaid Services (CMS) issued a final rule that updates payment rates and policies under the end-stage renal disease (ESRD) prospective payment system (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2024 This rule also updates the acute kidney injury (AKI) dialysis payment rate for renal dialysis
  • Financial Ties, Market Structure, Commercial Prices, and Medical . . .
    Those evaluated include dialysis facilities in the US, physicians involved with dialysis for patients enrolled in Medicare, and patients with end-stage renal disease enrolled in Medicare or one of the commercial insurers in claims data provided by the Health Care Cost Institute Data were analyzed from April 2024 to April 2025
  • Two companies control majority of dialysis market, study says
    DaVita and Fresenius control 77% of dialysis market, driving higher costs and medical director compensation, Duke study finds Medicare spends$40B annually
  • A Quick Summary of 2024 Medicare Changes that Affect Dialysis Patients
    A Quick Summary of 2024 Medicare Changes that Affect Dialysis Patients This blog post was made by Beth Witten, MSW, LSCSW on December 21, 2023 “Change is the law of life And those who look only to the past or present are certain to miss the future ”—John F Kennedy With that pithy quote, here are the Medicare changes for 2024 to the ESRD PPS, QIP, Part A and B costs, Medicare Advantage
  • Medicare Coverage for Dialysis in 2025: What You Need to Know
    Understanding Dialysis and Medicare Coverage Living with kidney disease can be challenging, but Medicare provides crucial support for individuals requiring dialysis treatments In 2025, Medicare continues to offer comprehensive coverage for patients with End-Stage Renal Disease (ESRD), ensuring access to essential medical services that can significantly improve quality of life What is End





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