Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services
This one time notification provides clarification on how a physician or practitioner should bill for end stage renal disease (ESRD) related services in the following situations: patients in hospital observation status; partial month scenarios (e.g., patient had a kidney transplant during the month); transient patients (patient travels away from home for less than full month) and when the beneficiary has a change in their monthly capitation payment physician during the month. Additional clarification is provided regarding billing for outpatient ESRD-related services when the beneficiary changes modalities during the month (e.g., a home dialysis patient who switches to center dialysis and vice versa).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 17, 2004
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