42 CFR §413.172
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Payment for renal dialysis services as defined in § 413.171 and home dialysis services as defined in § 413.217 of this chapter are based on payment rates set prospectively by CMS.
- (b)All approved ESRD facilities must accept the prospective payment rates established by CMS as payment in full for covered renal dialysis services as defined in § 413.171 or home dialysis services. Approved ESRD facility means—
- (1)Any independent ESRD facility or hospital-based provider of services (as defined in § 413.174(b) and § 413.174(c) of this part) that has been approved by CMS to participate in Medicare as an ESRD supplier; or
- (2)Any approved independent facility with a written agreement with the Secretary. Under the agreement, the independent ESRD facility agrees—
- (i)To maintain compliance with the conditions for coverage set forth in part 494 of this chapter and to report promptly to CMS any failure to do so; and
- (ii)Not to charge the beneficiary or any other person for items and services for which the beneficiary is entitled to have payment made under the provisions of this part.
- (c)CMS publishes the methodology used to establish payment rates and the changes specified in § 413.196(b) in the Federal Register.