Ind. IHCP Hospice Services Provider Reference Module, Section 1, Dialysis for End-Stage Renal Disease During Hospice Stays

If a patient who is on dialysis for end-stage renal disease (ESRD) is admitted to hospice with a non-ESRD

primary diagnosis, such as chronic obstructive pulmonary disease (COPD) or Alzheimer’s, the patient may

continue to receive dialysis treatments during the hospice stay.

Chapter 9, Section 40.1, of the Medicare Benefit Policy Manual (CMS Pub. 100-02), states that any item or

service that is included in the plan of care, and for which payment may be otherwise made by Medicare, is

a covered hospice service under the Medicare hospice benefit. So if the hospice is responsible for providing

all services indicated in the plan of care as reasonable and necessary for the palliation and management of

the terminal illness, then dialysis, in this case, is a covered hospice service. However, there is no additional

payment made. Most hospices have across-the-board admission policies indicating that they do not accept

patients who still want to receive dialysis, which hospice providers can do as long as they do not

discriminate against Medicare patients.