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Ohio Part B Carrier
ESRD: Other than Home Dialysis Patients

Direct patient care services related to Monthly Capitation Payments (MCP) for End Stage Renal Disease (ESRD) patients are submitted with a single HCPCS code per month, by the physician or non-physician practitioner (NPP) that has primary responsibility for managing the patient's ESRD, using the appropriate code for the patient's age and the number of face-to-face visits for the month.
 
Patient Age
Number of Visits per Month
HCPCS Code
(Dates of Service Prior to 1/1/09)
CPT Code
(Dates of Service on or after 1/1/09)
Under 2
4 or more
G0308
90951
2 – 3
G0309
90952
1
G0310
90953
Ages 2 – 11
4 or more
G0311
90954
2 – 3
G0312
90955
1
G0313
90956
Ages 12 – 19
4 or more
G0314
90957
2 – 3
G0315
90958
1
G0316
90959
Ages 20 and over
4 or more
G0317
90960
2 – 3
G0318
90961
1
G0319
90962
 
Documentation and Claim Submission:
  • MCP services require documentation of a complete assessment. The plan of care must be established (for new patients) or updated as needed (for established patients).
  • Non-physician practitioners (NPPs) are permitted to perform these services based on their scope of practice, as defined by Ohio and West Virginia state law
Resources

 

last updated on 03/25/2009
CMS