Payment for ESRD-related services (Per Diem)

140.2 - Payment for ESRD-related services (Per Diem) (Rev. 1456, Issued: 02-22-08, Effective: 03-24-08, Implementation: 03-24-08) Physicians and practitioners may receive payment for managing patients on dialysis for less than a full month of care in specific circumstances as discussed in this section. Payment for ESRD related services, less than a full month, is paid on a per diem basis. Per diem ESRD-related services should be coded using the ESRD related services (less than full month), per day HCPCS codes for ESRD-related services furnished in the situations described below. • Home dialysis patients (less than full month); • Transient patients – Patients traveling away from home (less than full month); • Partial month where there was one or more face-to-face visits without a complete assessment of the patient and the patient was either hospitalized before a complete assessment was furnished, dialysis stopped due to death, or the patient had a transplant. • Patients who have a permanent change in their MCP physician during the month. The ESRD-related services (less than full month), per day HCPCS codes should only be used for the circumstances described above. The per diem codes may not be used for a full month when a complete monthly assessment is not furnished.