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Dossier Executive proposed rule 26-jun-2026 Comment closes · 24-aug-2026
Draft regulation published for public comment — not yet in force.

Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury Dialysis (AKI) Payment, and ESRD Quality Incentive Program

Key claim: CMS proposes to update payment rates and quality incentive requirements for the ESRD Prospective Payment System and acute kidney injury dialysis for calendar year 2027.

Abstract

(Proposed Rule · Health and Human Services Department, Centers for Medicare & Medicaid Services) This proposed rule would update and revise the End-Stage Renal Disease (ESRD) Prospective Payment System for calendar year 2027. This rule also proposes to update the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. In addition, this rule proposes to update the requirements for the ESRD Quality Incentive Program.

Why this matters

The ESRD PPS bundled payment and QIP directly shape access to and quality of dialysis care for Medicare beneficiaries with kidney failure, and the same rate structure is used to pay for AKI dialysis in outpatient facilities. Even routine annual updates change what dialysis providers are paid and which quality measures they must meet, with downstream effects on facility viability, particularly in underserved areas.

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Briefing card

Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury Dialysis (AKI) Payment, and ESRD Quality Incentive Program
Stage: proposed rule · federal-register · 26-jun-2026

CMS proposes to update payment rates and quality incentive requirements for the ESRD Prospective Payment System and acute kidney injury dialysis for calendar year 2027.

Cross-references (0)

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External: fedreg:2026-12925

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