Calculation of the Basic Case-Mix Adjusted Composite Rate and

20.1 – Calculation of the Basic Case-Mix Adjusted Composite Rate and the ESRD Prospective Payment System Rate (Rev. 12979; Issued: 11-22-24; Effective: 01-01-25; Implementation: 01-06-25) A case mix methodology adjusts the composite payment rate based on a limited number of patient characteristics. Variables for which adjustments will be applied to each facility’s composite rate include age, body surface area (BSA), and low body mass index (BMI). These variables are determined in the ESRD PRICER to calculate the final composite rate (including all other adjustments). Effective January 1, 2011 the ESRD PPS replaced the basic case-mix adjusted composite rate payment system. See section 20 for information on the calculation of the ESRD PPS per treatment payment amount.