CMS Pub. 100-04, ch. 8, § 100.1

Home or Usual Facility

(Rev. 10640, Issued:08-06-21, Effective:09-07-2021, Implementation:09-07-21)

When a dialysis patient whose attending physician receives a monthly payment receives

maintenance dialysis services of any kind outside the usual setting from any physician

who is neither the attending physician nor that physician’s substitute, the following

procedures apply:

• The physician who furnished the service submits a claim to the local A/C MAC

(B) of jurisdiction;

• The A/B MAC (B) will process the claim and send an MSN to the patient;

• The A/B MAC (B) that has jurisdiction over the usual dialysis setting adjusts the

MCP to the usual attending physician to account for the time the patient was

absent from the usual dialysis setting.

• The A/B MAC (B) that has jurisdiction over the usual dialysis setting adjusts the

MCP to the usual attending physician per §140.3.E below to account for the time

the patient was absent from the usual dialysis setting.

A/B MACs (B) must notify physicians that claims for services furnished to temporary

patients must be identified as a claim for a temporary patient. The physician must

indicate “temporary patient” on the claim.