ESRD Payment Changes for 2009

End stage renal disease (ESRD) facilities can expect a 1 percent increase to the ESRD composition payment rate and a reduction in the drug add-on adjustment from 15.5 percent to 15.2 percent as a result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008.

As mandated by MIPPA, the resulting base rate of $133.81 and per treatment drug add-on amount of $20.33 applies to both hospital-based dialysis facilities and independent dialysis facilities.

Other changes include an update to the wage index adjustments to reflect the current wage data; and a reduction in the wage index floor from 0.7500 to 0.7000 which after applying a budget neutrality of 1.056689 results in a wage index floor of 0.7397.

These changes go into effect Jan. 1, 2009.


For more details, read Transmittal 98 and Transmittal 1648 on CMS’s Web site.

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