42 CFR Subpart H - Subpart H—Payment for End-Stage Renal Disease (ESRD) Services

  1. § 413.170 Scope.
  2. § 413.171 Definitions.
  3. § 413.172 Principles of prospective payment.
  4. § 413.174 Prospective rates for hospital-based and independent ESRD facilities.
  5. § 413.176 Amount of payments.
  6. § 413.177 Quality incentive program payment.
  7. § 413.178 ESRD quality incentive program.
  8. § 413.180 Procedures for requesting exceptions to payment rates.
  9. § 413.182 Criteria for approval of exception requests.
  10. § 413.184 Payment exception: Pediatric patient mix.
  11. § 413.186 Payment exception: Self-dialysis training costs in pediatric facilities.
  12. § 413.194 Appeals.
  13. § 413.195 Limitation on Review.
  14. § 413.196 Notification of changes in rate-setting methodologies and payment rates.
  15. § 413.198 Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.
  16. § 413.200 [Reserved]
  17. § 413.202 Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
  18. § 413.203 Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
  19. § 413.210 Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.
  20. § 413.215 Basis of payment.
  21. § 413.217 Items and services included in the ESRD prospective payment system.
  22. § 413.220 Methodology for calculating the per-treatment base rate under the ESRD prospective payment system effective January 1, 2011.
  23. § 413.230 Determining the per treatment payment amount.
  24. § 413.231 Adjustment for wages.
  25. § 413.232 Low-volume adjustment.
  26. § 413.233 Rural facility adjustment.
  27. § 413.234 Drug designation process.
  28. § 413.235 Patient-level adjustments.
  29. § 413.236 Transitional add-on payment adjustment for new and innovative equipment and supplies.
  30. § 413.237 Outliers.
  31. § 413.239 Transition period.
  32. § 413.241 Pharmacy arrangements.
Source:
62 FR 43668, Aug. 15, 1997, as amended at 86 FR 73515, Dec. 27, 2021, unless otherwise noted.