Frequency of Hemodialysis

Medicare covers hemodialysis up to three treatments per week (13–14/month) and will only reimburse more-than-three weekly sessions when medically necessary for listed indications (e.g., uncontrolled volume/ultrafiltration, heart failure, pericarditis, metabolic derangements, uncontrolled hypertension, or inadequate dialysis from hypotension/access issues), while planned short/inadequate dialysis and sessions for patient/staff convenience are excluded. Key requirements: each additional session must be ordered and fully supported in the medical record (updated Plan of Care, clinician/dialysis notes with legible provider signature), use the appropriate modifiers (KX and/or CG as applicable), document attempts to address recurring needs, and failure to provide this documentation will result in denial.

"Metabolic conditions (acidosis, hyperkalemia, hyperphosphatemia)"