Goodsurance

Costs & IRMAA

CMS Finalizes 2027 Medicare Dialysis Payment Rate at 297 Dollars and 52 Cents, With a Larger Add-On for Home Dialysis Training

A final rule issued October 28 sets the per-treatment base rate for kidney dialysis facilities and raises the payment designed to encourage training patients to do dialysis at home.

By the Goodsurance editorial teamOctober 29, 2026

On October 28, 2026, the Centers for Medicare and Medicaid Services issued its final rule updating payment rates under the Medicare End-Stage Renal Disease Prospective Payment System for calendar year 2027.

The new base rate is 297.52 dollars per dialysis treatment, up from 281.71 dollars in 2026. Of that increase of 15.81 dollars, 12.85 dollars comes from CMS bundling phosphate binder drugs directly into the base rate. Kidney patients take phosphate binders regularly to control mineral buildup; those medications had previously been billed separately under Medicare. Because the spending was already occurring, the move does not represent entirely new money. CMS projects the full rule will increase total payments to dialysis facilities by approximately 2.7 percent.

Medicare's 2027 dialysis payment rate rises to 297.52 dollars per treatment, and the home-dialysis training add-on jumps from 95.60 to 138.00 dollars.

Medicare expects to pay about 7.0 billion dollars in 2027 to the roughly 7,600 freestanding and hospital-based dialysis facilities nationwide that serve Medicare beneficiaries with end-stage renal disease.

The rule also raises the add-on payment that dialysis facilities receive when they train patients to perform treatments at home. That adjustment increases from 95.60 dollars to 138.00 dollars per training session beginning January 1, 2027. Home dialysis can offer flexibility for some patients with kidney failure, and the higher training add-on is intended to encourage facilities to support that pathway.

The ESRD Quality Incentive Program, which reduces Medicare payments to facilities that fall below certain quality thresholds, is also updated under the rule. The Acute Kidney Injury dialysis payment rate for 2027 is set at 297.52 dollars, matching the ESRD base rate. The final rule takes effect January 1, 2027.

In plain words

Medicare pays clinics to run dialysis treatments for people whose kidneys have stopped working. Starting January 2027, Medicare will pay those clinics 297.52 dollars per treatment. That is more than the 281.71 dollars paid this year. Part of the increase bundles in a kidney medicine that was already being paid for separately, so the net new money is smaller than the total increase looks. Overall, Medicare expects total payments to dialysis clinics to rise about 2.7 percent. About 7,600 clinics will share about 7.0 billion dollars in Medicare payments next year. The rule also raises what clinics get paid when they teach a patient to do dialysis at home. That training payment goes from 95.60 dollars to 138.00 dollars per session. The idea is to help more patients have the option to treat themselves at home if that works for them.

Understand the basics first

Source: CMS
Read at the source →

More news

Other stories on what is moving in Medicare.

Costs & IRMAA

OIG: Medicare Could Have Saved 255 Million Dollars by Screening New Hospice Enrollees Without Recent Hospital Visits

Federal auditors found documentation problems in 45 of 100 reviewed new hospice enrollment records and say targeted eligibility screening by Medicare contractors could prevent hundreds of millions in improper payments.

October 26, 2026

Costs & IRMAA

Medicare's Hospital Fund Is Projected to Fall Short of Full Payment Capacity by 2033, Trustees Report Finds

The 2026 Medicare Trustees Report projects the Part A Hospital Insurance fund will be partially depleted in 2033, at which point incoming revenues would cover only 89 percent of covered costs, absent new legislation.

October 26, 2026

Costs & IRMAA

KFF: Nearly Half of Traditional Medicare Beneficiaries Hold Medigap, as Average Monthly Premiums Reach 244 Dollars

A KFF analysis released two days before open enrollment finds 12.9 million people carry supplemental Medigap policies, that average premiums rose 7 percent in a single year, and that Plan G now covers nearly half of all policyholders.

October 15, 2026

Costs & IRMAA

Social Security Confirms 3.6 Percent Benefit Increase for 2027, the Largest Since 2023

The Social Security Administration released its official cost-of-living adjustment today, finalizing a figure that carries direct implications for what Medicare beneficiaries pay for Part B coverage next year.

October 14, 2026

Costs & IRMAA

MedPAC Opens Study of Whether Medicare Payments Match Actual Costs for Nursing Facilities and Home Health

The congressional advisory commission for Medicare has launched a formal workplan to examine whether two major post-acute care payment overhauls from 2019 and 2020 have kept reimbursement in line with what patient care actually costs.

October 10, 2026

Costs & IRMAA

KFF: Medicare Cost-Sharing Consumed More Than a Third of Average Social Security Income in 2023

A new KFF brief, released five days before open enrollment begins, assembles 2026 premiums, deductibles, and out-of-pocket limits across traditional Medicare, Medicare Advantage, and Part D in one place.

October 10, 2026