US · guidance
CMS Pub. 100-04, ch. 16, § 40.6.2.1
Separately Billable ESRD Laboratory Tests Furnished by Hospital-Based
Facilities
(Rev. 3425, Issued: 12-18-15, Effective: 01-01-16, Implementation: 01-04-16)
Independent laboratories and independent dialysis facilities with the appropriate clinical laboratory
certification in accordance with CLIA may be paid for ESRD clinical laboratory tests that are separately
billable. The laboratories and independent dialysis facilities are paid for separately billable clinical laboratory
tests according to the Medicare laboratory fee schedule for independent laboratories. (See §40.3 for details on
Part B hospital billing rules for laboratory services.)
Hospital-based laboratories providing separately billable laboratory services to dialysis patients of the
hospital’s dialysis facility or any other dialysis facility bill and are paid in accordance with the hospital
outpatient laboratory provisions in Chapter 16, section 40.3.
History
(Rev. 3425, Issued: 12-18-15, Effective: 01-01-16, Implementation: 01-04-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7df8885d881c021268d6d035035a61a155cf7a56a90ea9431f6a4624a25c73f0
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