42 C.F.R. § 413.182 Criteria for approval of exception requests.
Title 42 - Public Health
(a) CMS may approve exceptions to a pediatric ESRD facility's prospective payment rate if the pediatric ESRD facility did not have an approved exception rate as of October 1, 2002. (b) The pediatric ESRD facility must demonstrate, by convincing objective evidence, that its total per treatment costs are reasonable and allowable under the relevant cost reimbursement principles of part 413 and that its per treatment costs in excess of its payment rate are directly attributable to any of the following criteria: (1) Pediatric patient mix, as specified in §413.184. (2) Self-dialysis training costs in pediatric facilities, as specified in §413.186. [70 FR 70331, 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
§ 413.182 Criteria for approval of exception requests.
