ESRD Reports and Educational Resources
This webpage provides educational resources for the End Stage Renal Disease (ESRD) provider community.
Analysis of the ESRD PPS Payment Model
CMS contracted with a data contractor to conduct research and analysis to refine the case-mix adjustment model. Below, we will post information about this project as it progresses.
Data Collection
A Technical Expert Panel (TEP) was held on December 6, 2018 to discuss options for improving data collection for refining the ESRD PPS case-mix adjustment model. This TEP represented the first step in acquiring stakeholder and expert input to inform these refinements. The slides used during this TEP, as well as a report that summarizes the discussion and recommendations of the Technical Expert Panel, may be found below:
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Presentation December 2021 (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Summary Report April 2022 for December 2021 TEP (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Presentation December 2020 (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Summary Report April 2021 for December 2020 TEP (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Presentation December 2019 (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Summary Report May 2020 for December 2019 TEP (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Presentation December 2018 (PDF)
- End Stage Renal Disease Prospective Payment System Technical Expert Panel Summary Report June 2019 for December 2018 TEP (PDF)
- CY 2022 ESRD PPS RFI Summary of Comments
- CY 2023 ESRD PPS RFI Summary of Comments
- CY 2024 ESRD PPS RFI Summary of Comments
- CMS Decision Memos
- CMS Manual References
- Medicare Claims Processing Manual, Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims (PDF)
- Medicare Claims Processing Manual, Chapter 16 - Laboratory Services (PDF), Section 40.6 and Exhibit 1.
- Medicare Benefit Policy Manual, Chapter 11 - End Stage Renal Disease (ESRD) (PDF)
- Medicare Secondary Payer (MSP) Manual, Chapter 2 - MSP Provisions (PDF), Section 20
- Medicare Coverage Database
- Medicare Coverage Database - search National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions
- Medicare Coverage of Kidney Dialysis and Kidney Transplant Services
- Medicare Learning Network® (MLN) Resources
- MLN Matters® Articles – search database for national CMS articles related to ESRD
- Legislative Citations
- Section 153(b) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
- Section 3401(h) of the Patient Protection and Affordable Care Act (the Affordable Care Act or ACA)
- Section 632 of the American Taxpayer Relief Act of 2012 (ATRA)
- Section 217 of Protecting Access to Medicare Act of 2014 (PAMA)
- Section 204 of Stephen Beck, Jr., Achieving a Better Life Experience Act of 2014 (ABLE)
- Section 808 of the Trade Preferences Extension Act of 2015
- Reports
- Analysis to Support the 2016 Refinements to the ESRD PPS (PDF) 6/2016
- Analysis to Inform the Design and Implementation of the End-Stage Renal Disease Prospective Payment System (PDF) 12/2015
- End Stage Renal Disease Payment System: Results of Research on Case-mix Adjustment for an Expanded Bundle (PDF) 2/2008
- A Design for a Bundled End Stage Renal Disease Prospective Payment System (PDF) 2008 Report to Congress
- Other ESRD Related Websites
- Dialysis Facility Compare
- End Stage Renal Disease and Clinical Laboratories Open Door Forums
- End Stage Renal Disease (ESRD) Center
- Erythropoietin Stimulating Agents Policies
- ESRD Network Organizations
- ESRD PC Pricer
- ESRD Quality Incentive Program
- Medicare Part B Drug Average Sales Price
- National Kidney Disease Education Program (NKDEP)
- Preventive Services
- Survey & Certification - Certification & Compliance - Transplant
- Survey & Certification - Guidance to Laws & Regulations - Dialysis
- Telehealth