This page is a central location for end-stage renal disease (ESRD) information, including CMS resources.

Spotlight

• Calendar Year (CY) 2026 End-Stage Renal Disease (ESRD) Prospective Payment System Final Rule

Policy Information

Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of a LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.

LCDs

Learn more about the LCD development process through the following:

• LCD Development Process
• Journey to LCD Coverage

Search for ESRD-related LCDs using these available tools:

• LCD Interactive Index Tool
• View active / proposed LCDs on CMS Medicare Coverage Database (MCD)

NCD

Search for ESRD related NCDs using these available tools:

• Search CMS’ MCD

Medical Documentation

For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to ESRD, but may not address all required medical documentation requirements:

• Medical Documentation Checklists
• Checklist: ESRD

Claim Submission and Reimbursement

• Acute Kidney Injury (AKI)
• ESRD Billing Requirements
• Ending AX Modifier Requirements for AKI and ESRD
• ESRD Billing Reminders and Quarterly Updates
• ESRD: Payment for Phosphate Binders Effective January 1
• Resolution Tips for Overlapping Claims

Additional Information

• View our FastTrack to Medicare Coverage Policies tool to locate guidelines

CMS

• End Stage Renal Disease Facility Providers
• ESRD PPS Patient-Level Adjustments
• ESRD Payment Regulations and Notices
• Erythropoietin Stimulating Agents Policies
• ESRD Network Organizations
• ESRD PPS Consolidated Billing
• End Stage Renal Disease (ESRD) Prospective Payment System (PPS)
• ESRD Quality Incentive Program
• End-Stage Renal Disease Information Center
• CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 11
• CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 8
• CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 16
• CMS IOM Pub. 100-05 Medicare Secondary Payer (MSP) Manual, Chapter 2 

Education

View our wide selection of free, live and on-demand training options:

• Educational Events Calendar
• On-Demand Learning

Stay Informed

Stay updated on the latest Medicare information with free email subscriptions:

• Subscribe to eNews
• CMS.gov MLN Connects Newsletter