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.
The 1Q24 update includes all sheets and input factors updated with the following:
- Implementation of the Post-TDAPA payment add-on for Korsuva™ (difelikafalin)
- Implementation of the Transitional Pediatric ESRD Add-on Payment Adjustment (TPEAPA)
- Removal of Provision to estimate payments for the Capital Related Assets Adjustment (CRA) for the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) for patients using the Tablo home hemodialysis system
As in past releases, in addition to all system-wide trend factors, multipliers, drug costs, etc., facility-level data has been updated to use facility-specific 2022 cost reports, PY2024 QIP Performance scores, estimated facility-average case-mix (based on 2022 claims), and 2024 wage indices to assist in using the calculator for specific renal dialysis units, based on Medicare CCN.
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.