US · guidance
CMS Pub. 100-04, ch. 8, § 50.6
In-Facility Back-Up Dialysis
Back-up dialysis is an in-facility dialysis treatment furnished to a home dialysis patient.
Condition code 76 must appear as one entry in Form Locators (FLs) 24-30. The facility
must explain why any in-facility backup dialysis sessions (furnished on either an
inpatient or outpatient basis) are furnished to home dialysis patients who are covered
under the Prospective Payment System (PPS) base rate. If a backup session is furnished
because of a failure to furnish any of the required items or services, then it will be
covered only to the extent of a home dialysis session and reimbursed at the facility’s PPS
base rate. If the backup dialysis is furnished by an institution other than the home
patient’s End Stage Renal Disease (ESRD) facility, then the ESRD facility must assume
financial liability for any cost or charge in excess of the ESRD facility’s PPS base rate
except where the patient is traveling away from home.
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
b9ceb316750dff1e73e8bfaf46632b54cae90ea967e64a8f34fb6b277df8c187
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