How does Medicare pay for PD treatments as a primary payer under Method I?
A dialysis clinic bills the Medicare Intermediary for dialysis. The Medicare Intermediary pays for PD based on a week of hemodialysis at 80% of the allowed rate less $1.50 per week to pay for ESRD Network services. Therefore, Medicare pays the same amount for a week of PD treatment as it pays under the composite rate for a week of hemodialysis treatments, no matter how many days or PD exchanges the patient does. See Chapter 8, ยง80.4 of the Medicare Claims Processing Manual.
