2025-12368Proposed RuleSignificantWallet

Medicare Tweaks Kidney Dialysis Payments for 2026

Published Date: 7/2/2025

Proposed Rule

Summary

Starting in 2026, Medicare is updating how it pays for kidney dialysis and care for people with serious kidney problems. These changes affect patients with end-stage kidney disease and those with sudden kidney injuries, aiming to improve care quality and payment fairness. Some programs will be updated or ended, so providers and patients should get ready for new rules and payment rates.

Analyzed Economic Effects

4 provisions identified: 2 benefits, 0 costs, 2 mixed.

ESRD Payment System Updated for 2026

If you have Medicare and receive care for end-stage renal disease (ESRD), Medicare proposes updates to the ESRD Prospective Payment System for calendar year 2026. These changes affect how Medicare pays for kidney dialysis and related services starting in 2026.

Payment Rate for AKI Dialysis Updated

If you have Medicare and receive renal dialysis for acute kidney injury (AKI), Medicare proposes to update the payment rate for those dialysis services. The proposal applies as part of the overall changes for calendar year 2026.

ESRD Treatment Choices Model Altered

Medicare proposes to terminate and modify requirements for the ESRD Treatment Choices Model. If you are a Medicare beneficiary affected by that model, its termination or changes could alter how the model's rules apply to your care.

ESRD Quality Incentive Program Changes

If you receive dialysis covered by Medicare, the proposal would update requirements for the End-Stage Renal Disease (ESRD) Quality Incentive Program for calendar year 2026. These updates affect the program that measures and sets requirements tied to ESRD care quality.

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Key Dates

Published Date
Effective Date
7/2/2025
1/1/2026

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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