Daily Hemodialysis and Hemodialysis in the Home Setting

This policy covers conventional hemodialysis performed in the home setting (up to three times per week) and allows a fourth home HD treatment in a week when ESRD patients have conditions refractory to routine thrice-weekly HD (e.g., hyperkalemia, pregnancy, fluid overload, acute pericarditis, congestive heart failure, pulmonary edema, severe catabolic state). Eligibility requires end‑stage renal disease with stable, well‑functioning vascular access, demonstrated adherence and ability/motivation to perform home HD (or availability of a trained caregiver or professional staff), suitable home facilities and timely access to professional support; daily hemodialysis, wearable/implantable artificial kidneys, and services excluded by the member’s contract or state regulations are considered experimental/unproven or not covered.

"Conventional hemodialysis (HD) up to 3 times per week in the home setting for patients with end-stage renal disease (ESRD) who are stable during HD treatment."