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Freestanding End-Stage Renal Disease Facility Reimbursement Rates

This page serves as a central repository for rates within the TRICARE Freestanding ESRD Facility Reimbursement System. The table below shows the current and historical data related to Freestanding ESRD facility payments.

Based on the Final Rule (32 CFR 199) that was published on November 6th, 2023, the TRICARE Freestanding ESRD facility reimbursement rates will be effective from January 1, for the calendar year (CY) 2024. See 32 CFR 199.14(c) for Freestanding ESRD facility payment system updates. The TRICARE Freestanding ESRD facility payment system is modeled on the Medicare Prospective Payment System for ESRD facilities and uses annually updated items and numbers from the Medicare ESRD PPS as provided for in this part and in instructions issued by the Director, Defense Health Agency.

Please be advised that TRICARE Reimbursement Manual (TRM) Chapter 6 Section 7, Hospital Reimbursement - TRICARE Diagnosis Related Group (DRG)-Based Payment System (Adjusted Standardized Amounts (ASAs)), Paragraph 3.2.7, Labor-Related and Non-Labor-Related Portions of the ASA, lists incorrect labor and non-labor related portions of the ASA. For Calendar Year 2024, for wage index values greater than 1.0, the labor related portion of the ASA is 67.6%, and the non-labor related portion is 32.4%. The correct values are incorporated in the information on this web page. TRM Chapter 6 Section 7 Paragraph 3.2.7 is in the process of being corrected

The effective date of these items and numbers shall not correspond to that under Medicare PPS but shall be delayed until January 1, to align with TRICARE's program year reporting. This allows for administrative simplicity, optimizing healthcare delivery by reducing the existing administrative burden and costs.

Please be advised that TRICARE Reimbursement Manual (TRM), Chapter 18 Section 1 Paragraph 7 (2015), Freestanding End Stage Renal Disease (ESRD) Facility Reimbursement, list an incorrect policy effective date for dialysis services rendered in freestanding ESRD facilities. The correct effective date for which services were rendered on or after is January 12, 2023.

TRICARE ESRD Facility Reimbursement Rates

Changes to TRICARE ESRD Facility Reimbursement Rates. This table demonstrates the calculation for a wage-adjusted per-session rate for a facility with a wage index of 1.12.

  CY24 CY23
Days 0-120 Per-Session Rate   $384.82  $377.08
Days 121-Forward Per-Session Rate  $289.99  $284.16
 Labor Share of Per-Session Rate  $212.42  $208.15
 Wage Index-Adjusted Labor Share  $237.91  $233.13
 Non-Labor Share of Per-Session  $172.40  $168.93
 Final Waged-Adjusted Per-Session Rate  $410.31  $402.06
 Training Add-On Payment  $95.60  $95.60

Last Updated: June 27, 2024
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