# Federal Register #2026-22194

CMS Finalizes Medicare ESRD Dialysis Payment and Quality Program Updates

**Buyer:** Centers for Medicare & Medicaid Services (CMS), U.S. Department of Health and Human Services
**Posted:** October 30, 2026
**Identifier:** 2026-22194

CMS finalized Medicare payment and quality-program updates for dialysis services; this notice is a regulatory rule, not a procurement opportunity.
- **Government buyer and issuing agency:** U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS).
- **What the rule changes:** Updates the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS), acute kidney injury (AKI) dialysis payments, and ESRD Quality Incentive Program (QIP) requirements.
  - The ESRD PPS base rate and AKI dialysis payment rate are both **$297.52 per treatment**; applicable wage-index adjustments apply to AKI payments.
  - The rule incorporates phosphate binders into the ESRD PPS base rate and revises low-volume facility, pediatric, home-dialysis training, and drug add-on payment policies.
  - Named drug products **DefenCath** and **Vafseo** are discussed in connection with drug add-on payment adjustments; no manufacturers or vendors are identified.
- **Quality-program changes:** The rule adds a hyperphosphatemia clinical measure, revises a bloodstream-infection measure, removes two reporting measures, and changes measure-domain weights.
- **Procurement details:** No products or services are being solicited for purchase. No procurement quantities, part numbers, contract value, or OEMs are specified.

### Description

This final rule updates and revises the End-Stage Renal Disease (ESRD) Prospective Payment System for calendar year 2027. It also updates the payment rate for renal dialysis services furnished by ESRD facilities to individuals with acute kidney injury. In addition, it updates requirements for the ESRD Quality Incentive Program. The regulations are effective January 1, 2027.

[View original listing](https://www.federalregister.gov/documents/2026/10/30/2026-22194/medicare-program-cy-2027-changes-to-the-end-stage-renal-disease-esrd-prospective-payment-system)