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Costs & IRMAA

CMS Proposes Raising the Medicare Dialysis Rate to 299 Dollars and 55 Cents for 2027

A proposed rule issued in June would increase the per-treatment base rate by about 1.1 percent and move phosphate binders into the bundled payment for the first time. The public comment period closed August 24.

By the Goodsurance editorial teamAugust 29, 2026

CMS issued a proposed rule on June 24, 2026 to update the Medicare End-Stage Renal Disease Prospective Payment System for calendar year 2027. The public comment period closed on August 24, 2026.

Under the proposal, the per-treatment base rate paid to dialysis facilities would rise to 299 dollars and 55 cents, up from the current 281 dollars and 71 cents. CMS projects the change would increase total Medicare dialysis payments by approximately 1.1 percent, reaching about 6.2 billion dollars in annual payments to roughly 7,600 ESRD facilities nationwide.

CMS proposes raising the Medicare dialysis base rate to 299 dollars and 55 cents per treatment for 2027, including phosphate binders in the bundle for the first time.

A structural change is embedded in the proposed rate. Phosphate binders, medications routinely prescribed to people on dialysis to manage a common complication of kidney failure, would be included in the bundled per-treatment payment for the first time. CMS noted that this addition accounts for a substantial portion of the rate difference; the underlying market-basket update driving the remainder is smaller.

The rule also proposes updates to the payment rate for dialysis furnished to patients with acute kidney injury treated at certified ESRD facilities, and changes to quality reporting requirements under the ESRD Quality Incentive Program.

CMS plans to finalize the rule later this fall. Any changes would take effect January 1, 2027.

In plain words

Medicare pays a set amount to dialysis clinics for each treatment session given to patients with kidney failure. CMS wants to change that rate for 2027. Under the plan, each session would be paid at 299 dollars and 55 cents, up from 281 dollars and 71 cents today. That is about a 1.1 percent increase. Part of the increase comes from adding a type of medicine called phosphate binders into the payment bundle for the first time. About 7,600 dialysis facilities around the country would be affected. CMS will finalize the plan later this fall, and any new rates would start January 1, 2027.

Understand the basics first

Source: CMS
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