How Medicare and Medicaid's 2025 Physician Payment Policy Benefits Kidney Patients

Every year, the Centers for Medicare and Medicaid Services (CMS) updates the rules about how doctors are paid. These updates are important because they can affect the care kidney patients receive. In the fall, CMS published the final physician payment policies for 2025. We at National Kidney Foundation (NKF) are excited to share some positive news for the kidney community!

Physician payment policies are the rules that CMS uses to decide how doctors and other healthcare providers are paid for their services. These policies change every year, and CMS asks the public to share feedback on the proposed changes before making them final.

Earlier this fall, NKF wrote about CMS’ proposals in the Physician Fee Schedule (PFS) and what those would mean for our community. Read here.

NKF sent a letter to CMS, sharing the topics important to kidney patients, their communities, and the professionals who care for them.

NKF focused on a few key areas:

• Dental services
• Expanding access to compound immunosuppressive drugs
• Telehealth services
• Caregiver training for home dialysis
• Quality measures

After reading feedback from the public, CMS made its final decisions.

CMS finalized its physician payment policies for the calendar year beginning January 1, 2025. We are excited to share victories for the kidney patient community! 

Here are some of the biggest changes in the finalized 2025 policies that can help kidney patients:

1. Dental Services Coverage

CMS will now cover certain dental services for kidney failure patients on Medicare. These services include dental care linked to dialysis treatment or needed to prevent or treat infections.

2. Caregiver Training

In 2025, CMS will allow some caregiver training through telehealth. This means that caregivers can get the support they need without leaving home. Curious how this policy could help you? Get in touch with NKF toll-free at 855.NKF.CARES (855.653.2273) or email nkfcares@kidney.org.

3. Telehealth Services

NKF continues to push for more telehealth services. CMS has finalized a policy that allows some telehealth appointments to be audio-only. This can be helpful if your internet connection isn’t strong enough for video calls or if you prefer not to be on camera.

4. Immunosuppressive Drugs Coverage

Thanks to years of hard work by NKF Voices for Kidney Health advocates, Medicare now covers immunosuppressive drugs for kidney transplant patients for life. Starting in 2025, CMS will include oral and enterally administered immunosuppressive drugs with compounded formulations in this coverage.

Learn more about the immunosuppressive drug coverage for transplant patients.

These new policies will hopefully make a big difference in the lives of kidney patients, improve treatment, and help make healthcare access more equal for all.

Learn about NKF’s Kidney Equity For All™ initiative.

We always want to hear from our community about how Medicare can work better for you. Make your voice heard. Become a Voices for Kidney Health advocate today.