Question:

Does Medicare reimburse ESRD-related laboratory tests?

Answer:

According to the Medicare Claims Processing Manual (MCPM), chapter 16, section 40.6, all laboratory services related to end-stage renal disease (ESRD) are included in the ESRD prospective payment system (PPS) base rate. They must be reported by the ESRD facility and are not separately paid.

The list of ESRD-related laboratory tests that are routinely performed for the treatment of ESRD can be found in the Downloads section at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/Consolidated_Billing.html.

 

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