New PPS for End Stage Renal Dialysis Facilities Effective January 1, 2011


CMS issued a final rule on July 23, 2010 that creates a new bundled prospective payment system (PPS) for facilities that furnish renal dialysis services and home dialysis to Medicare beneficiaries with End-Stage Renal Disease (ESRD). This new

rule replaces the current system, which pays facilities a composite rate for a defined set of items and services, while paying separately for drugs, laboratory tests, or other services that are not included in the composite rate. Under the new

ESRD PPS, CMS will make a single bundled payment to the dialysis facility for each dialysis treatment that will cover all renal dialysis services and home dialysis. The new bundled payment system will be effective for dialysis treatments furnished

to beneficiaries on or after Jan. 1, 2011. Ober|Kaler's Susan A. Turner explains.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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