Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 337.00 - Rates for Dialysis Treatments and Home Dialysis Supplies
Section 337.03 - Rate(s) Determination

Universal Citation: 101 MA Code of Regs 101.337

Current through Register 1518, March 29, 2024

(1) Rates paid to providers will be subject to the following adjustments and limitations:

(a) In a case where the established charge(s) is lower than the ESRD program rate(s) and is not based upon an established income-related sliding fee scale for self-payers, the established charge(s) is the rate(s) paid to the provider.

(b) If home training is included as part of a provider's ESRD program, governmental purchasers and purchasers under M.G.L. c. 152 who choose to purchase the service, must pay the ESRD program rate(s) plus an add-on listed in 101 CMR 337.03(3) under the appropriate service code.

(2) Rates for Chronic Maintenance Dialysis Treatment.

Procedure Code

Description

Rate

90999

Unlisted dialysis procedure, inpatient or outpatient

(all-inclusive service per dialysis treatment per patient)

$185.18

The all-inclusive rate identified in 101 CMR 337.03(2) covers all services and supplies as defined in 42 CFR 410.50, with the exception of physician services.

(3) The following codes and add-ons must be used when the treatment includes these services:

Procedure Code

Description

Rate

90989

Dialysis training, patient, including helper where applicable, any mode, completed course

$20.00

90993

Dialysis training, patient, including helper where applicable, any mode, course not completed, per training session

$20.00

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