US · guidance
CMS Pub. 100-04, ch. 8, § 50.1
Laboratory Services Included in the End Stage Renal Disease
Prospective Payment System ESRD PPS
(Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21)
With the implementation of the End Stage Renal Disease Prospective Payment System
ESRD PPS, effective for claims with dates of service on or after January 1, 2011, all
ESRD-related laboratory services are included in the ESRD PPS base rate.
f the renal dialysis facility needs to report a lab service that was not related to the
treatment of ESRD, they must include the modifier AY to indicate the item or service is
not for the treatment of ESRD.
ESRD-related lab services that were separately paid under the basic case-mix composite
rate payment system are considered in the calculation of any applicable outlier payment
under the ESRD PPS.
History
(Rev. 10640, Issued:08-06-21, Effective:09-07-21, Implementation:09-07-21)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7bb14ab107655ce5ab917166de35736504763b5a3a287ab1f83bc993ece30323
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.