The End-Stage Renal Disease (ESRD) 2020 proposed rule was published in the Federal Register August 6, 2019, and affects discharges on or after January 1, 2020. Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc., and for calendar year (CY) 2020, CMS has proposed the following updates to the End-Stage Renal Disease rates:
|
Description |
Current Rate |
Proposed Rate |
% Change |
|
PPS Base Rate |
$235.27 |
$240.27 |
2.13% |
|
Fixed Dollar Loss - Pediatric |
$57.14 |
$44.91 |
-21.40% |
|
Fixed Dollar Loss - Adult |
$65.11 |
$52.50 |
-19.37% |
|
Medicare Allowable Payment - Pediatric |
$35.18 |
$33.82 |
-3.87% |
|
Medicare Allowable Payment - Adult |
$38.51 |
$36.60 |
-4.96% |
Additional items to note from our recent review of the ESRD proposed rule include:
-
CMS is proposing updates to the acute kidney injury (AKI) payment. The payment will equal the proposed CY 2020 ESRD PPS base rate adjusted for wage index. The AKI dialysis payment will be $240.27.
-
CMS is proposing to no longer update the Transitional Drug Add-On Payment Adjustment for new drugs and biologicals if they don’t receive data within the required timeline. The timeline can be referenced in the proposed rule.
-
CMS is proposing new quality measures for 2020.
The full version of the proposed rule can be viewed here. Public comments can be submitted through 5pm EST on September 27, 2019.
If you liked this post, you may enjoy reading other 2020 proposed rule posts including:
