CMS Finalizes 2027 ESRD Payment Rule: $297.52 Base Rate, About $7B to Roughly 7,600 Dialysis Facilities
The Centers for Medicare & Medicaid Services (CMS) on October 28 issued the calendar year 2027 End-Stage Renal Disease (ESRD) Prospective Payment System final rule (CMS-1846-F), effective January 1, 2027.
Under the rule, the 2027 base rate for dialysis treatments is $297.52, an increase of $4.97 over 2026. CMS estimates total payments of about $7 billion to roughly 7,600 facilities, with freestanding facilities gaining about $17.2 million in aggregate and hospital-based facilities losing about $900,000. Payments are projected to rise 0.4% for urban facilities and 0.9% for rural ones.
The rule implements Section 4133 of the Inflation Reduction Act, which revised the ESRD outlier payment policy, and continues monitoring of the $21 add-on payment for ACIP-recommended vaccines administered to dialysis patients. CMS also finalized a 1.5% payment update for 2026 and applied a budget-neutral wage-index adjustment of negative 0.0795%.
The ESRD payment system is Medicare's main mechanism for paying for dialysis for patients with kidney failure, and its rates directly affect dialysis providers nationwide and patient access to treatment.
Source: GSM · USA (original Chinese edition)
Photo: 图：美国卫生与公众服务部总部 Hubert H. Humphrey 大楼，联邦医保与医疗补助服务中心（CMS）隶属该部。照片：公共领域，经 Wikimedia Commons。 / Photo: The Hubert H. Humphrey Building, headquarters of HHS, home department of CMS. Public domain, via Wikimedia Commons.
