Renal Dialysis Items and Services

20 - Renal Dialysis Items and Services (Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26) Medicare provides payment under the ESRD PPS for all renal dialysis services for outpatient maintenance dialysis, when they are furnished to Medicare ESRD patients, for the treatment of ESRD by a Medicare- certified ESRD facility or a special purpose renal dialysis facility. Renal dialysis services are the items and services included under the composite rate and the items and services that were separately paid as of December 31, 2010 that were used for the treatment of ESRD. Renal dialysis services are furnished in various settings, including hospital outpatient ESRD facilities, independent ESRD facilities, or in the patient’s home. Renal dialysis items and services furnished at ESRD facilities or in the patient’s home differ according to the types of patients being treated, the types of equipment and supplies used, the preferences of the treating physician, and the capability and makeup of the staff. Although not all facilities provide an identical range of services, the most common elements of renal dialysis treatment include: • Laboratory tests; • Drugs and biological products; • Equipment and supplies - dialysis machine use and maintenance; • Personnel services; • Administrative services; • Overhead costs; • Monitoring access and related de-clotting or referring the patient, and • Direct nursing services, which include registered nurses, licensed practical nurses, technicians, social workers, and dietitians.