Section 1881 (b)(12) of the Social Security Act, as amended by section 623 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, establishes the End Stage Renal Disease (ESRD) composite rate payment method for most dialysis related services provided by renal dialysis facilities to Medicare beneficiaries with end stage renal disease. 

This PC Pricer software allows users to enter information to predict reimbursement to a renal dialysis facility based on the type of dialysis and various patient characteristics.  It contains the same payment logic used to calculate composite rate payments for type of bill 72x in the Medicare mainframe system.

See Core-Based Statistical Area (CBSA) Information below.

Note: Printing from this PC Pricer requires the use of a post-script driver.

Downloads
Please follow the download instructions available at the link titled "Guidelines for Downloading and Executing PPS PC Pricers".  This PC Pricer may be downloaded to a hard drive or network drive.  CY2008.5 – Updated 08/20/08 [ZIP, 1MB] ESRD Calculator [ZIP, 120KB] (updated 12/28/07)
Related Links Inside CMS
Limited Data Set - ESRD Composite Rate Payment System File End Stage Renal Disease (ESRD) Quality Initiative End Stage Renal Disease (ESRD) Center CY 2008 Physician Fee Schedule (PFS) Final Rule with Comment: CMS-1385-FC (Final Rule and Associated Data Files) -- (On Display November 1, 2007; Published November 27, 2007) – See Provisions Related to Payment for Renal Dialysis Services Furnished By End-Stage Renal Disease (ESRD) Facilities {Current CY 2008 wage index data are on page 66284 of the 11/27/2007 Federal Register notice}[PDF, 3MB]
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 09/02/2008 11:49:59 AM
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