Dynamic List Information
Dynamic List Data
Transmittal #
R12029CP
Issue Date
2023-05-11
Subject
Quarterly Update to the End-Stage Renal Disease Prospective Payment System (ESRD PPS)
Implementation Date
2023-07-03
CR #
13201
Provider Education
MLN Connects Newsletter Message
Provider Education Release Date
2023-06-15
Publication #
100-04
Transmittal Year
2023
MLN Connects® Newsletter Message
ESRD Prospective Payment System: July Update
See the instruction to your Medicare Administrative Contractor for updates to the ESRD Prospective Payment System, including:
- Attachment A: CMS made routine changes to the list of outlier services effective July 1, 2023:
- Updated the mean unit cost for renal dialysis drugs that are oral equivalents to injectable drugs based on the most recent prices from the Medicare Prescription Drug Plan Finder
- Added or removed renal dialysis items and services
- Revised the mean dispensing fee of qualifying National Drug Codes (NDCs) to $0.50 per NDC per month
- Attachment B: We updated the Consolidated Billing list effective April 1, 2023, to replace J0610 with J0612 in the Bone and Mineral Metabolism category