RSE ESRD PPS Calculator
The RSE ESRD PPS Calculator is designed to show monthly payments and costs. Users can reconcile actual Medicare payments via the calculator to ensure they are being reimbursed appropriately.
Developed by Mark Stephens of Prima Analytics, this valuable business tool provides key reports such as monthly facility revenue, cost and profit analysis, case-mix analysis, and a three-year forecast.
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The 3Q24 update includes all sheets and input factors updated with the following:
- New provision for TDAPA payment calculations for DEFENCATH (taurolidine and heparin sodium), which was approved for TDAPA reimbursement starting July 1, 2024. Q3 2024 TDAPA Payment rate update for Jesduvroq (daprodustat).
- Updated average sales prices (ASPs) for Part B drugs, reflecting Q124 actual prices from the July 2024 pricing file.
- Updates per the Q3 2024 Outlier Services tables, including updated payment limits for calcimimetics.
- Updated trend factors for 2024-2026 for the Three-Year Forecast module from the latest ESRD Market Basket Forecast and from trend factors mentioned in the 2025 PPS Proposed Rule.
ACCESS
The ESRD PPS Calculator is accessible only to Renal Healthcare Association members, it is a complementary tool that members receive as a member benefit. If you are an RHA Member visit the Tools & Resources Library on the online member community Voices to download the latest version (Renal Healthcare Association member login is required).
Not a Member? Join today and enjoy all the member benefits including complimentary access to the RSE Bundle PPS Calculator.
Learn more about how to use this tool to benefit their facility by viewing a previously recorded webinar on Education Station.
This tool is updated periodically to reflect the most recent industry data set.