CMS proposes CY2027 ESRD payment rate above $299 for the first time

Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below.

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Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below.

American Health Intel
Rules · Money · Medicine · Decoded daily
The Service Line Monday, July 27, 2026
CMS proposes CY2027 ESRD payment rate above $299 for the first time
Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below.
Rule  Confidence: High
CMS, the Medicare agency, just proposed raising the dialysis payment rate to $299.55 a treatment for 2027, the first time it has climbed above $299, while reshaping how facilities get paid for new drugs.
The proposal raises home dialysis training pay and adds a new post-drug-add-on payment category, projecting a 1.1% overall payment increase for dialysis facilities. Comments close August 24, 2026.
Why it matters
Medicare pays for the vast majority of dialysis treatments, so this rate sets the baseline economics for the whole industry; watch whether the 1.1 percent bump survives to the final rule this fall.
Sources: CMS · Federal Register
Rule  Confidence: High
Nephrology groups in Medicare's Kidney Care Choices model, a value-based kidney care program, just lost the $15,000 bonus they earned for every successful kidney transplant.
CMS's innovation center also cut quarterly chronic kidney disease payments 50% and added a 1% benchmark discount, after the model posted $304 million in net losses model-wide.
Why it matters
This is a real cut to a Medicare value based kidney care program that lost money; watch how many nephrology practices stay in the model through 2027 versus shifting to MSSP ACOs.
Also today
California vascular access doctor settles for $6.73M Read
Dialysis facility closures outpace openings for first time this decade Read
GLP-1s slow kidney decline as Medicare shifts transplant incentives to hospitals Read
$1.8 billion: the operator metric for nephrology alignment deals Read
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