Transition from AKI to ESRD

100.6.8 Transition from AKI to ESRD (Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26) Regarding transitioning patients from AKI to ESRD, CMS maintains flexibility for physicians to determine when an AKI patient has regained kidney function, or whether the transition must be made to ESRD treatment. This is a medical decision that should be supported by laboratory tests and the withdrawal of dialysis to determine the extent of recovery of renal function. The goal of AKI treatment should be to have the kidneys return to normal functioning. Physicians complete the ESRD Medical Evidence Report for Medicare Entitlement and/or Patient Registration (CMS 2728, OMB No. 0938-0046) to formally transition the patient from AKI to ESRD for the purposes of registering the patient as an ESRD beneficiary and ensuring appropriate payment under the Medicare ESRD benefit. 100.6.9 Transitional Drug Add-On Payment Adjustment (TDAPA) and Transitional Add-On Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) (Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26) As of January 1, 2021, the TDAPA and TPNIES are payment policies under the ESRD PPS and are only applicable for ESRD beneficiaries; therefore, the TDAPA and TPNIES are not applicable to renal dialysis services provided to beneficiaries who have AKI.