Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20.2
Pediatric Payment Model for ESRD PPS
20.2 - Pediatric Payment Model for ESRD PPS
(Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21)
The pediatric payment model applies to all dialysis patients that are under the age of 18.
The model uses the ESRD PPS base rate applicable to adult dialysis patients which is
then adjusted by separate adjusters based on two age groups (<13, 13-17), and dialysis
modality (HD, PD).