US · guidance
CMS Pub. 100-04, ch. 8, § 20.3
End Stage Renal Disease Quality Incentive Program (ESRD QIP)
153c of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
required The Centers for Medicare & Medicaid Services (CMS) to implement a quality
based payment program for dialysis services with payment consequences effective
January 1, 2012. The measures are defined in the annual dialysis facility report (DFR)
that each provider receives in addition to the final rule.
Contractors are notified annually through a Technical Direction Letter from CMS
identifying ESRD facilities subject to QIP payment reduction. Medicare contractors shall
update the outpatient provider specific file (OPSF) as indicated for the payment year
specified.
See chapter 4 of this manual for appropriate OPSF fields to update.
Valid values for ESRD facilities:
Blank = no reduction
1 = ½ percent payment reduction
2 = 1 percent payment reduction
3 = 1 ½ percent payment reduction
4 = 2 percent payment reduction
History
(Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7c253dad2847feb7148add2622f478fb948144955649aebc24459959d50fbab3
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