No-Shows

10.3 - No-Shows (Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21) If a facility sets up in preparation for a dialysis treatment, but the treatment is never started because the patient never arrives, no payment is made. In this case, no service has been furnished to a Medicare beneficiary even though staff time and supplies may have been used. Furthermore, the facility may not bill the patient or the patient’s private insurance for these services. This is because the program is already paying the cost of pre-dialysis services through the PPS base rate. In setting that rate, CMS has included the salaries of facility personnel and the cost of supplies used for furnishing pre-dialysis services. Therefore, these costs (e.g., salaries for staff time, overhead, supply costs) are included in the facility’s costs and reported on its cost report, and they are included in the allowable costs used to set future reimbursement rates under the End Stage Renal Disease Prospective Payment System (ESRD PPS) for ESRD facilities. However, these costs may not be used as the basis for a facility to be reimbursed as Medicare bad debts.