Covered Services

Covered Services A. The Division of Medicaid covers: 1. Hemodialysis, 2. Peritoneal dialysis, 3. Continuous Ambulatory Peritoneal Dialysis (CAPD), and 4. Continuous Cyclic Peritoneal Dialysis (CCPD). B. Prior authorization is not required for dialysis services. C. The Division of Medicaid covers: 1. All resources used in providing outpatient dialysis services, including supplies and equipment used to administer dialysis in the ESRD (end stage renal disease) facility or at a beneficiary’s home, drugs, biologicals, laboratory tests, and support services under the bundled ESRD PPS (prospective payment system) rate, 2. Professional services, 3. Antibiotics, when used at home by a beneficiary, to treat an infection of the catheter site or peritonitis associated with peritoneal dialysis, and 4. Specified lab tests and injectable drugs not included in the bundled ESRD PPS rate, when medically necessary.