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Code of Federal Regulations (Last Updated: May 6, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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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. |
| § 413.188 - Payment exception: Extraordinary circumstances. |
| § 413.190 - Payment exception: Self-dialysis training costs. |
| § 413.192 - Payment exception: Frequency of dialysis. |
| § 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. |