Thursday, December 1, 2022
HomeLatest NewsFederal NewsCMS Releases CY 2020 End-Stage Renal Disease and DMEPOS Final Rule

CMS Releases CY 2020 End-Stage Renal Disease and DMEPOS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating the end-stage renal disease (ESRD) prospective payment system (PPS) and policies related to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for calendar year (CY) 2020. The provisions of the final rule are effective on Jan. 1.

The final rule establishes a new process for determining fee schedule amounts for new DMEPOS items, under which the agency will use the fee schedule amounts for the older items to establish the payment amounts for the new items. If there is no comparison, the fee schedule will be based on commercial pricing data, including internet retail prices.

In addition, CMS has finalized policies intended to streamline requirements for ordering DMEPOS items, including clarifying the documentation necessary to satisfy face-to-face encounter requirements, and standardized elements for written orders. CMS has also developed a single list of DMEPOS items potentially subject to a face-to-face encounter; written orders prior to delivery; and/or prior authorization requirements.

CMS has adopted an ESRD PPS base rate of $239.33, an increase of $4.06 compared to CY 2019. In addition, CMS has established a transitional add-on payment for facilities that introduce new renal dialysis equipment and supplies for two calendar years. CMS estimates that the updates for CY 2020 will increase the total payments to all ESRD facilities by 1.6% compared with CY 2019. For hospital based ESRD facilities, CMS projects an increase in total payments of 2.1 percent.

CMS also finalized several changes to the ESRD Quality Incentive Program, including updating the scoring methodology for the National Healthcare Safety Network Dialysis Event. Notably, CMS did not finalize its proposal to revise the scoring methodology for the Medication Reconciliation measure. Additional information on the final rule is available in a CMS fact sheet.​

 

Stay Connected

Unified Voice Newsletter

Events This Month

december

01dec11:30 am12:30 pmPalliative Care State of the Field 2022CAPC Webinar

01dec12:30 pm1:30 pmPalliative Care: End of Life Decisions: Ethical and Legal Aspects of Palliative CareProject ECHO

01dec2:00 pm3:30 pmHome Health Regulatory Update for 2023SDAHO Webinar

02decAll Day032nd Annual Walking Forward Health Forum and Policy Symposium

06dec11:00 am12:00 pmEarly Childhood Comprehensive Systems (ECCS) CollaborativeSDAHO Webinar


By submitting this form, you are consenting to receive marketing emails from: SDAHO, 3708 W Brooks Place, Sioux Falls, SD, 57106, http://sdaho.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact