Quarterly Update to the End-Stage Renal Disease Prospective Payment System (ESRD PPS)

MLN Matters Number: MM12741
Related CR Release Date: May 4, 2022
Related CR Transmittal Number: R11401CP
Related Change Request (CR) Number: 12741
Effective Date: July 1, 2022
Implementation Date: July 5, 2022

CR 12741 tells you about:

  • Revised list of outlier services to include 27 National Drug Codes (NDCs), effective January 1, 2022
  • Updated mean unit cost for renal dialysis drugs that are oral equivalents to injectable drugs, effective July 1, 2022
  • Revised mean dispensing fee for NDCs qualifying for outlier to $0.57 per NDC per month, effective July 1, 2022

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12741.


Last Updated May 11 , 2022