§ 413.230 - Determining the per treatment payment amount.  


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  • § 413.230 Determining the per treatment payment amount.

    The per-treatment payment amount is the sum of:

    (a) The per treatment base rate established in § 413.220, adjusted for wages as described in § 413.231, and adjusted for facility-level and patient-level characteristics described in §§ 413.232 and 413.235 of this part;

    (b) Any outlier payment under § 413.237;

    (c) Any training adjustment add-on under § 413.235(c);

    (d) Any transitional drug add-on payment adjustment under § 413.234(c); and

    (e) Any transitional add-on payment adjustment for new and innovative equipment and supplies under § 413.236(d); and

    (f) Any add-on payment adjustment for new renal dialysis drugs or biological products in existing ESRD PPS functional categories after the payment period for the transitional drug add-on payment adjustment has ended, as described in § 413.234(c)(3) and (g).

    [75 FR 49200, Aug. 12, 2010, as amended at 84 FR 60803, Nov. 8, 2019; 88 FR 76505, Nov. 6, 2023]