1. (a) Measurement Years. CMS assesses ETC Participant performance on the home dialysis rate and the transplant rate during each of the MYs. The first MY begins on January 1, 2021, and the final MY ends on December 31, 2024.
2. (b) Performance Payment Adjustment Period. CMS adjusts payments for ETC Participants by the PPA during each of the PPA Periods, each of which corresponds to a MY. The first PPA Period begins on July 1, 2022, and the final PPA Period ends on December 31, 2025.

3. (c) Measurement Years and Performance Payment Adjustment Periods. MYs and PPA Periods follow the following schedule:

   Table 1 to Paragraph (c)—ETC Model Schedule of Measurement Years and PPA Periods

   Measurement Year (MY)	Performance Payment Adjustment (PPA) period
   MY 1—1/1/2021 through 12/31/2021	PPA Period 1—7/1/2022 through 12/31/2022.
   MY 2—7/1/2021 through 6/30/2022	PPA Period 2—1/1/2023 through 6/30/2023.
   MY 3—1/12022 through 12/31/2022	PPA Period 3—7/1/2023 through 12/31/2023.
   MY 4—7/1/2022 through 6/30/2023	PPA Period 4—1/1/2024 through 6/30/2024.
   MY 5—1/1/2023 through 12/31/2023	PPA Period 5—7/1/2024 through 12/31/2024.
   MY 6—7/1/2023 through 6/30/2024	PPA Period 6—1/1/2025 through 6/30/2025.
   MY 7—1/1/2024 through 12/31/2024	PPA Period 7—7/1/2025 through 12/31/2025.

[85 FR 61362, Sept. 29, 2020, as amended at 90 FR 53139, Nov. 24, 2025]