Intradialytic Parenteral/Enteral Nutrition (IDPN)

60.5 - Intradialytic Parenteral/Enteral Nutrition (IDPN) (Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21) A. General Parenteral/enteral nutrition (PEN) administered during dialysis may be covered under Medicare, but it is not part of the Medicare ESRD benefit. Therefore, an ESRD facility or PEN supplier may bill Medicare separately for PEN solution if the patient meets all of the requirements for PEN coverage. (See Medicare Benefit Policy Manual for PEN coverage requirements.) If the ESRD facility bills, it does so as a PEN supplier and bills the appropriate DME MAC. B. Staff Time The ESRD facility staff time used to administer PEN solution is not covered by Medicare, and, therefore, not included in the ESRD PPS. (PEN is considered a self- administered therapy and generally administered in the patient’s home.) Since it is not covered under Medicare, it is not part of the ESRD PPS nor may a facility bill Medicare separately for it.