Response to Comments: Frequency of Hemodialysis

This policy permits payment for hemodialysis beyond the CMS thrice-weekly baseline when a claim cites a clinical condition on the contractor's approved list and supporting medical documentation demonstrates medical necessity. Treatments not on the list may be submitted with a KX modifier and considered after additional review; MACs cannot change CMS baseline payment policies and appeals are available following initial denials.

"Payment for hemodialysis treatments beyond the CMS thrice-weekly baseline may be authorized when the claim lists a clinical condition that appears on the contractor's approved list and accompanying..."

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