Frequency of Hemodialysis

Medicare covers conventional hemodialysis for patients with ESRD as three sessions per week (13/14 per month); additional sessions beyond three per week may be covered only when a documented clinical indication exists and the KX modifier is applied. Covered indications include uncontrolled metabolic disturbances (acidosis, hyperkalemia, hyperphosphatemia), volume overload, pregnancy, heart failure, pericarditis, and incomplete dialysis due to hypotension or access problems; robust POC documentation (including Kt/V ≥1.2 and POC parameters per 42 CFR 494.90) and reassessment are required. Sessions planned as inadequate/short or provided for convenience are not covered, and continued unusual use of extra sessions may trigger medical review or denial.

"Patients with end stage renal disease (ESRD) receiving conventional hemodialysis are covered for dialysis treatments, with conventional therapy delivered three times per week as the standard."