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

1. CFR
2. ›
3. Title 42
4. ›
5. Chapter IV
6. ›
7. Part 413
8. ›
9. Subpart H

Sections

Section numbering in the official eCFR can be non-consecutive. Omitted section numbers are not treated here as reserved unless the source explicitly labels them that way.

• 413.170
  § 413.170 Scope.
• 413.171
  § 413.171 Definitions.
• 413.172
  § 413.172 Principles of prospective payment.
• 413.174
  § 413.174 Prospective rates for hospital-based and independent ESRD facilities.
• 413.176
  § 413.176 Amount of payments.
• 413.177
  § 413.177 Quality incentive program payment.
• 413.178
  § 413.178 ESRD quality incentive program.
• 413.180
  § 413.180 Procedures for requesting exceptions to payment rates.
• 413.182
  § 413.182 Criteria for approval of exception requests.
• 413.184
  § 413.184 Payment exception: Pediatric patient mix.
• 413.186
  § 413.186 Payment exception: Self-dialysis training costs in pediatric facilities.
• 413.194
  § 413.194 Appeals.
• 413.195
  § 413.195 Limitation on Review.
• 413.196
  § 413.196 Notification of changes in rate-setting methodologies and payment rates.
• 413.198
  § 413.198 Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.
• 413.200
  § 413.200 [Reserved]
• 413.202
  § 413.202 Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
• 413.203
  § 413.203 Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
• 413.210
  § 413.210 Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.
• 413.215
  § 413.215 Basis of payment.
• 413.217
  § 413.217 Items and services included in the ESRD prospective payment system.
• 413.220
  § 413.220 Methodology for calculating the per-treatment base rate under the ESRD prospective payment system effective January 1, 2011.
• 413.230
  § 413.230 Determining the per treatment payment amount.
• 413.231
  § 413.231 Adjustment for wages.
• 413.232
  § 413.232 Low-volume adjustment.
• 413.233
  § 413.233 Additional facility-level adjustments.
• 413.234
  § 413.234 Drug designation process.
• 413.235
  § 413.235 Patient-level adjustments.
• 413.236
  § 413.236 Transitional add-on payment adjustment for new and innovative equipment and supplies.
• 413.237
  § 413.237 Outliers.
• 413.239
  § 413.239 Transition period.
• 413.241
  § 413.241 Pharmacy arrangements.