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- Code of Federal Regulations
- C.F.R. Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER B—MEDICARE PROGRAM
- PART 413—PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES; PAYMENT FOR ACUTE KIDNEY INJURY DIALYSIS
- Subpart H—Payment for End-Stage Renal Disease (ESRD) Services
42 C.F.R. § 413.217
Items and services included in the ESRD prospective payment system.
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Source: 75 FR 49200, Aug. 12, 2010
Table of Contents
Subpart H—Payment for End-Stage Renal Disease (ESRD) Services
- §413.170 Scope.
- §413.171 Definitions.
- §413.172 Principles of prospective payment.
- §413.174 Prospective rates for hospital-based and independent ESRD facilities.
- §413.176 Amount of payments.
- §413.177 Quality incentive program payment.
- §413.178 ESRD quality incentive program.
- §413.180 Procedures for requesting exceptions to payment rates.
- §413.182 Criteria for approval of exception requests.
- §413.184 Payment exception: Pediatric patient mix.
- §413.186 Payment exception: Self-dialysis training costs in pediatric facilities.
- §413.194 Appeals.
- §413.195 Limitation on Review.
- §413.196 Notification of changes in rate-setting methodologies and payment rates.
- §413.198 Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.
- §413.200 [Reserved]
- §413.202 Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
- §413.203 Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
- §413.210 Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.
- §413.215 Basis of payment.
- §413.217 Items and services included in the ESRD prospective payment system.
- §413.220 Methodology for calculating the per-treatment base rate under the ESRD prospective payment system effective January 1, 2011.
- §413.230 Determining the per treatment payment amount.
- §413.231 Adjustment for wages.
- §413.232 Low-volume adjustment.
- §413.233 Rural facility adjustment.
- §413.234 Drug designation process.
- §413.235 Patient-level adjustments.
- §413.236 Transitional add-on payment adjustment for new and innovative equipment and supplies.
- §413.237 Outliers.
- §413.239 Transition period.
- §413.241 Pharmacy arrangements.