So, here’s a brief thread on the 2021 Medicare fee schedule final rule that came out this evening, brief mainly because CMS pretty much finalized everything as proposed. This means the substantial increases in value for outpatient dialysis services are maintained. /1 The increase for home dialysis was finalized at the 5.52 level outlined in Addendum B of the rule, not the 8.04 level included in a chart in the proposed in error. 5.52 is still a hefty bump, >25%, but not what it would have been at 8.04. /2

So, here are some ruminations on the urgent, out of cycle rulemaking CMS released tonight to address outstanding telehealth issues during the COVID PHE. First, it is an interim final rule, so what came out tonight is official policy. @RPANephrology 1/ Second, it seems to remove any doubt that all ESRD MCP interactions can be provided by telehealth. Not that nephrologists shouldn’t see their patients when safe for all to do so, it’s just that telehealth can be used and billed for when that’s not that case. @RPANephrology 2/

Here is a mini tweet thread about the RFA for the voluntary kidney disease models released by CMS yesterday. First, the due date for applications is January 22, 2020 (!). Decisions will be made and applicants informed in 'Winter' 2020, with 2020 being an implementation year. (1) CMS will be doing all of the expected monitoring and oversight, interoperability will be required, using 2015 CEHRT, and CMS will be doing waivers for payment issues ('benefit enhancements') but not fraud and abuse issues at this time; OIG and the DOJ have to do those. (2)