CY 2025 ESRD PPS Final Provider Level Impact File										
										
Column	Title	Description								
A	Provider ID	Six character OSCAR Provider Number (CMS Certification Number). 								
B	Number of Dialysis Treatments	Hemo-equivalent treatments								
C	Total Payment for Step 1	"This is the baseline result for comparison purposes, which uses 2023 data with the predicted 2024 outlier thresholds from the previous FR2024. It uses 2024 prices, post-TDAPA add-on payments, CBSA delineations, and final 2024 wage indices."								
D	Total Payment for Step 1 Non-Outlier	"This is the baseline result for comparison purposes, which uses 2023 data with the predicted 2024 outlier thresholds from the previous FR2024. It uses 2024 prices, post-TDAPA add-on payments, CBSA delineations, and wage indices."								
E	Total Payment for Step 2	"This step updates the baseline result by enforcing the 1% outlier policy. This step uses the CY 2024 base rate.  In this step, the adult FDL is projected from the from the updated FDL methodology for CY 2023."								
F	Total Payment for Step 2 Non-Outlier	This is the baseline result without outlier payments.  This is the same as Step 1 Non-Outlier.								
G	Total Payment for Step 3	"This step updates the current single-tier LVPA adjuster to the scaled two-tier LVPA adjusters in adult EB multipliers, with budget neutrality maintained."								
H	Total Payment for Step 3 Non-Outlier	"This step updates the current single-tier LVPA adjuster to the scaled two-tier LVPA adjusters in adult EB multipliers, with budget neutrality maintained. This step does not include outlier payments."								
I	Total Payment for Step 4	"This step updates the post-TDAPA payment adjustment for CY2025 by applying the recalculated post-TDAPA add-on amount for each quarter of 2025.  Additionally, this step accounts for the end of TDAPA payments for drugs whose TDAPA period ends in 2024."								
J	Total Payment for Step 4 Non-Outlier	"This step updates the post-TDAPA payment adjustment for CY2025 by applying the recalculated post-TDAPA add-on amount for each quarter of 2025.  Additionally, this step accounts for the end of TDAPA payments for drugs whose TDAPA period ends in 2024.  This step does not include outlier payments."								
K	Total Payment for Step 5	"This step updates the outlier policy to treat CR drugs and formerly TDAPA drugs as outlier-eligible, adds post-TDAPA add-on payment to predicted SB MAP, and recalculates the FDLs by enforcing the 1% outlier policy."								
L	Total Payment for Step 5 Non-Outlier	"This step updates the outlier policy to treat CR drugs and formerly TDAPA drugs as outlier-eligible, adds post-TDAPA add-on payment to predicted SB MAP, and recalculates the FDLs by enforcing the 1% outlier policy. This step does not include outlier payments."								
M	Total Payment for Step 6	"This step updates wage indices to 2025 wage indices based on the new wage index methodology and new CBSA delineations. In this step, a phase-out of the rural adjustment is also applied for ESRD facilities switching from rural to urban status under the new CBSA delineations."								
N	Total Payment for Step 6 Non-Outlier	"This step updates wage indices to 2025 wage indices based on the new wage index methodology and new CBSA delineations. In this step, a phase-out of the rural adjustment is also applied for ESRD facilities switching from rural to urban status under the new CBSA delineations. This step does not include outlier payments."								
O	Total Payment for Step 7	This step applies a budget neutrality factor to account for the change in the wage index and rural adjuster.								
P	Total Payment for Step 7 Non-Outlier	This step applies a budget neutrality factor to account for the change in the wage index and rural adjuster. This step does not include outlier payments.								
Q	Total Payment for Step 8	"This step updates the base rate by the market basket update and the productivity adjustment.  In addition, 2025 prices based on ESRD drug inflation factor are used to calculate the TDAPA add-on, post-TDAPA add-on, outlier payments. In this step, adult FDL is projected from the refined FDL methodology, using the market basket and productivity adjusted and wage index budget neutralized base rate for 2025."								
R	Total Payment for Step 8 Non-Outlier	"This step updates the base rate by the market basket update and the productivity adjustment.  In addition, 2025 prices based on ESRD drug inflation factor are used to calculate the TDAPA add-on, post-TDAPA add-on, outlier payments. In this step, adult FDL is projected from the refined FDL methodology, using the market basket and productivity adjusted and wage index budget neutralized base rate for 2025.  This step does not include outlier payments."								
S	Rural	Identifies urban or rural status based on geographic location								
		Yes=Rural								
		No=Urban								
T	Hospital Based	Yes=Hospital-based								
		No=Freestanding								
U	"Low Volume (Less than 3,000 treatments)"	Identifies facilities that qualify for tier 1 of the low-volume adjustment								
		"Yes = Low Volume, Tier 1"								
		No = Not low volume tier 1								
V	"Low Volume (3,000 to 3,999 treatments)"	Identifies facilities that qualify for tier 2 of the low-volume adjustment								
		"Yes = Low Volume, Teir 2"								
		No = Not low volume teir 2								
W	Census Region	Identifies location of facility by Census Region								
X	State	Identifies the facility's state								
Y	Pediatric	Identifies percentage of pediatric patients								
		1=Less than 2%								
		2=From 2% to 19%								
		3=From 20% to 49%								
		4=50% or more								
Z	Size	Identifies size of facility based on total number of hemo-equivalent treatments (including treatments for non-Medicare patients)								
		"1=Less than 4,000 treatments"								
		"2=4,000 to 9,999 treatments"								
		"3=More than 10,000 treatments"								
		4=Unkown								
AA	Ownership	Identifies type of ownership by:								
		1=Large dialysis organization								
		2=Regional chain								
		3=Independent								
		4=Hospital-based								
		5=Unknown								
AB	For Profit	Identifies facilities profit status								
		1) Yes								
		2) No								
AC	2024 Wage Index	Final Wage Index for 2024								
AD	Final 2025 Wage Index	Final Wage Index for 2025 (using new methodology)								
AE	2025 Legacy Wage Index	Legacy Wage Index for 2025 (calculated using legacy methodology)								
