42 C.F.R. § 413.170 Scope.
Title 42 - Public Health
This subpart implements sections 1881 (b)(2) and (b)(7) of the Act by— (a) Setting forth the principles and authorities under which CMS is authorized to establish a prospective payment system for outpatient maintenance dialysis furnished in or under the supervision of an ESRD facility approved under subpart U of part 405 of this chapter (referred to as “facility” in this section). For purposes of this section and §413.172 through §413.198, “outpatient maintenance dialysis” means outpatient dialysis, home dialysis, self-dialysis, and home dialysis training, as defined in §405.2102 (f)(2)(ii), (f)(2)(iii), and (f)(3) of this chapter, and includes all items and services specified in §§410.50 and 410.52 of this chapter. (b) Providing procedures and criteria under which a pediatric ESRD facility (an ESRD facility with at least a 50 percent pediatric patient mix as specified in §413.184 of this subpart) may receive an exception to the prospective payment rates; and (c) Establishing procedures that a facility must follow to appeal its payment amount under the prospective payment system. [62 FR 43668, Aug. 15, 1997, as amended at 70 FR 70330, Nov. 21, 2005]
Title 42: Public Health
PART 413—PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES
Subpart H—Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs
§ 413.170 Scope.
