Medicare Benefit Policy Manual (Pub. 100-02), Ch. 11 § 100.6.6
ESRD Facility Conditions for Coverage (CfCs)
100.6.6 ESRD Facility Conditions for Coverage (CfCs)
(Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26)
The ESRD Facility CfCs at 42 CFR part 494 are health and safety standards that all
Medicare participating dialysis facilities must meet. These standards set baseline
requirements for patient safety, infection control, care planning, staff qualifications,
record keeping, and other matters to ensure that all patients, including ESRD and AKI
patients, receive safe and appropriate care.
100.6.7 Payment for Erythropoietin Stimulating Agents (ESAs) and the
ESA Monitoring Policy for AKI Patients
(Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26)
ESAs are included in the bundled payment amount for treatments administered to patients
with AKI. The Non-ESRD HCPCS codes should be used (J0881, J0883, J0885, J0888,
Q0138, Q5106) and reported using revenue code 0636.