U.S. FEDRegulation
CMS final rule sets CY 2027 ESRD prospective payment base rate at $297.52 under 42 CFR Part 413
The Centers for Medicare and Medicaid Services published a final rule on October 30, 2026 updating the End-Stage Renal Disease Prospective Payment System for calendar year 2027. The rule sets the per-treatment base rate at $297.52, updates payment for renal dialysis services for individuals with acute kidney injury, rebases the market basket to 2024, and updates the ESRD Quality Incentive Program. The rule takes effect January 1, 2027.
Key points
- The $297.52 base rate rises from $281.71 for CY 2026 and reflects a 1.9 percent market basket update.Federal Register
- The base rate adds $12.85 to incorporate phosphate binders into the bundled payment, with budget-neutrality adjustments applied.Federal Register
- For adult beneficiaries the outlier fixed dollar loss amount rises from $14.80 to $90.60; for pediatric patients, from $162.43 to $229.49.Federal Register
- The CY 2027 average per-treatment TPNIES offset amount for home dialysis machines is $10.63.Federal Register
- The rule is CMS-1846-F, RIN 0938-AV81, published at 91 FR 68736.Federal Register
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RegulationU.S.Medicare Program: CY 2027 End-Stage Renal Disease Prospective Payment System (42 CFR Part 413)HealthcareRegulatoryFor practitionersFor governance