Frequency of Hemodialysis

Medicare covers conventional hemodialysis at three sessions per week (13–14 sessions/month); additional sessions beyond 3/week are generally not payable unless supported by specific medical indications (e.g., metabolic acidosis, refractory volume overload, pregnancy, heart failure, pericarditis, incomplete dialysis due to hypotension or access issues) and documented medical necessity. Claims for >3 sessions/week must be supported by the patient Plan of Care (42 CFR 494.90), POC reassessment (42 CFR 494.80(d)), appropriate clinical documentation, and proper use of the KX modifier per Local Coverage Article A55723 and A56159; failure to meet documentation requirements or sessions provided for convenience will be denied.

"Additional hemodialysis sessions may be covered for metabolic acidosis not controlled with routine dialysis."

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