Services Covered Under the End Stage Renal Disease (ESRD)

80.5 - Services Covered Under the End Stage Renal Disease (ESRD) Program (Rev. 208, Issued: 04-22-15, Effective: 01-01-15, Implementation: 05-11-15) Renal dialysis services that are covered and paid for under the ESRD PPS, which include any item or service furnished to an ESRD beneficiary that is directly related to that individual's dialysis, are excluded from coverage under the Medicare home health benefit. However, to the extent that other requirements for coverage are met, an item or service that is not directly related to a patient's dialysis would be covered (e.g., a skilled nursing visit to furnish wound care for an abandoned shunt site). Within these restrictions, beneficiaries may simultaneously receive items and services under the ESRD PPS through their ESRD facility at home at the same time as receiving items and services under the home health benefit that are not related to ESRD.