联邦医保公布2027年终末期肾病支付终规：基础费率297.52美元，全年向约7600家透析机构支付约70亿美元
美国联邦医疗保险与医疗补助服务中心（CMS）于10月28日发布2027日历年终末期肾病（ESRD）预期支付系统最终规则（编号 CMS-1846-F），新规将于2027年1月1日生效。
按新规，2027年透析治疗的基础费率定为每次297.52美元，较2026年增加4.97美元。CMS 估计，全年将向约7,600家透析机构支付约70亿美元；其中独立透析机构合计多得约1,720万美元，医院附属机构合计少约90万美元。按地区看，城市机构支付预计上升0.4%，农村机构上升0.9%。
终规落实了《通胀削减法》第4133条对离群支付（outlier）政策的调整，并继续对接种 ACIP 推荐疫苗的透析患者给予每次21美元的附加支付监测安排。CMS 同时敲定2026年支付更新幅度为1.5%，并在工资指数上作了负0.0795%的预算中性调整。
终末期肾病支付系统是联邦医保为肾衰竭患者透析治疗付费的主要机制，费率调整直接影响全美透析机构的运营与患者的就诊可及性。
CMS Finalizes 2027 ESRD Payment Rule: $297.52 Base Rate, About $7B to Roughly 7,600 Dialysis Facilities
The Centers for Medicare & Medicaid Services (CMS) on October 28 issued the calendar year 2027 End-Stage Renal Disease (ESRD) Prospective Payment System final rule (CMS-1846-F), effective January 1, 2027.
Under the rule, the 2027 base rate for dialysis treatments is $297.52, an increase of $4.97 over 2026. CMS estimates total payments of about $7 billion to roughly 7,600 facilities, with freestanding facilities gaining about $17.2 million in aggregate and hospital-based facilities losing about $900,000. Payments are projected to rise 0.4% for urban facilities and 0.9% for rural ones.
The rule implements Section 4133 of the Inflation Reduction Act, which revised the ESRD outlier payment policy, and continues monitoring of the $21 add-on payment for ACIP-recommended vaccines administered to dialysis patients. CMS also finalized a 1.5% payment update for 2026 and applied a budget-neutral wage-index adjustment of negative 0.0795%.
The ESRD payment system is Medicare's main mechanism for paying for dialysis for patients with kidney failure, and its rates directly affect dialysis providers nationwide and patient access to treatment.
来源：GSM·美国（原文链接）
图片来源：图：美国卫生与公众服务部总部 Hubert H. Humphrey 大楼，联邦医保与医疗补助服务中心（CMS）隶属该部。照片：公共领域，经 Wikimedia Commons。 / Photo: The Hubert H. Humphrey Building, headquarters of HHS, home department of CMS. Public domain, via Wikimedia Commons.
