Payment for End-Stage Renal Disease (ESRD) Services | Midpage

Collections
Code of Federal Regulations

Subpart H

Payment for End-Stage Renal Disease (ESRD) Services

413.170Scope.413.171Definitions.413.172Principles of prospective payment.413.174Prospective rates for hospital-based and independent ESRD facilities.413.176Amount of payments.413.177Quality incentive program payment.413.178ESRD quality incentive program.413.180Procedures for requesting exceptions to payment rates.413.182Criteria for approval of exception requests.413.184Payment exception: Pediatric patient mix.413.186Payment exception: Self-dialysis training costs in pediatric facilities.413.194Appeals.413.195Limitation on Review.413.196Notification of changes in rate-setting methodologies and payment rates.413.198Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.413.200[Reserved]413.202Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.413.203Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.413.210Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.413.215Basis of payment.413.217Items and services included in the ESRD prospective payment system.413.220Methodology for calculating the per-treatment base rate under the ESRD prospective payment system effective January 1, 2011.413.230Determining the per treatment payment amount.413.231Adjustment for wages.413.232Low-volume adjustment.413.233Additional facility-level adjustments.413.234Drug designation process.413.235Patient-level adjustments.413.236Transitional add-on payment adjustment for new and innovative equipment and supplies.413.237Outliers.413.239Transition period.413.241Pharmacy arrangements.