Updated Form CMS-2728 Available in EQRS 

(October 2024)

July 11, 2024

On November 30, 2023, the Centers for Medicare & Medicaid Services (CMS) updated Form CMS-2728 (also known as the End Stage Renal Disease (ESRD) Medical Evidence Report Medicare Entitlement and/or Patient Registration) on CMS.gov with a note that a date for when Form CMS-2728 would be available in the ESRD Quality Reporting System (EQRS) was forthcoming.

CMS is happy to announce that effective October 1, 2024, the updated Form CMS-2728 will automatically generate in the EQRS Patient Registry application whenever an Initial, Re-entitlement, or Supplemental Form CMS-2728 is added. The EQRS version will align with the version as released on CMS.gov on this date.

The updated Form CMS-2728 in EQRS will capture additional patient details in sections A, B, C, and F. It will also contain anupdated International Classification of Diseases (ICD)-10 List of Primary Causes of Renal Disease. 

Please view the Reference Guide: Form CMS-2728 Updates for information on the new fields that will be required for successful submission to the Social Security Administration (SSA).

Additionally, users can also refer to the Form CMS-2728 Updates: FAQs document when completing Form CMS-2728. These resources are available on the Education page on www.MyCROWNWeb.org.

For assistance with EQRS technical issues, please contact the Center for Clinical Standards and Quality (CCSQ) Service Center. The CCSQ Service Center is open Monday-Friday 8 a.m. to 8 p.m. Eastern Time and can be reached via phone at 866-288-8912, email at qnetsupport-esrd@cms.hhs.gov or online at the CCSQ Support Center.

For assistance with general EQRS and ESRD QIP questions, please contact the ESRD QIP Team via the QualityNet Q&A Tool.