Reimbursement for 2020

Hi! Is there a separate reimbursement for hospitals that have an on-site outpatient PD clinic? So far all I can find for reimbursement is the bundled base rate calculated at 3 units of therapy per week and then the monthly capitation amount. Is there anything else?

Dialysis clinics are reimbursed a rate for peritoneal dialysis based on equivalency to hemodialysis, See Section 50A in the Medicare Benefit Policy Manual, Chapter 11. See #4 if PD is provided daily or #5 if intermittent PD is provided 3 times a week.

Assuming the hospital-based outpatient dialysis clinic is Medicare certified to provide the service of PD training and support, the reimbursement for PD would be under the ESRD PPS (bundled rate). The Medicare daily allowed charge is 3x the HD rate divided by 7. Medicare reimbursement is 80% after the Part B annual deductible is met. Here’s a like to the Medicare Benefit Pilicy Manual for ESRD.