Frequency of Hemodialysis

Medicare covers hemodialysis beyond the conventional 3 sessions/week for specific medical indications such as metabolic derangements (acidosis, hyperkalemia, hyperphosphatemia), refractory volume overload, pregnancy, heart failure, pericarditis, and incomplete dialysis due to hypotension or access issues when documented. Standard payment is limited to 3x/week (13–14 sessions/month); payments for more frequent treatments require documented medical necessity, appropriate use of the KX modifier per Local Coverage Article A55723, and supporting clinical documentation including POC information and objective measures (e.g., Kt/V).

"Additional hemodialysis sessions are covered for metabolic derangements such as metabolic acidosis, hyperkalemia, or hyperphosphatemia not correctable with routine 3x/week dialysis."

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