The Centers for Medicare & Medicaid Services (CMS) finalized Medicare payment policy updates for renal dialysis services provided to Medicare beneficiaries beginning January 1, 2021. The final rule includes an overall payment increase of 2.0 percent or $250 million for all ESRD facilities, while rural ESRD facilities are estimated to experience a 1.0 percent increase as a result of the proposed changes. Other policy changes include adoption of the 2018 OMB delineations, expansion of the list of new equipment and supplies, TPNIES, to include home dialysis machines, and updates to the low-volume payment adjustment due to the COVID-19 public health emergency.