Palmetto GBA
^ Back to Top
Close Window [x]
  • JM HHH
  • JM Part A
  • JM Part B
  • NSC
  • Railroad Beneficiaries
  • Railroad Providers

JM Transition Infominisurvey
Learn more about the transition 

Auxilary Aids & Services

For information about the availability of auxiliary aids and services, please visit:

Bookmark E-mail Print FB Like Show/Hide Google+ line
Standard Font Serif Font Decrease Font Size Increase Font Size

Jurisdiction 11 Part B
What is excluded in the monthly capitation payment (MCP)?

  • Administration of hepatitis B vaccine
  • Surgical services, such as:
    • Temporary/permanent hemodialysis catheter placement
    • Temporary/permanent peritoneal dialysis catheter placement
    • Repair existing dialysis access
    • Placement of catheter for thrombolytic therapy
    • Thrombolytic therapy
    • Thrombectomy of clotted cannula
    • Arthrocentesis
    • Bone marrow aspiration and biopsy
  • Interpretation of tests that have a professional component, such as:
    • Electrocardiograms (EKGs, or ECGs) 
    • Echocardiograms
    • 24-hour blood pressure monitor
    • Biopsies
    • Spirometry and complete pulmonary function tests (PFTs)
  • Complete evaluation for renal transplant. Note: Assessment of whether the patient meets preliminary criteria as transplant candidate is included in MCP, but the complete evaluation is excluded from MCP.
  • Evaluation of potential living transplant donors
  • Training patients to perform home or self hemodialysis and various forms of self peritoneal dialysis
  • Non-renal related physician's services (may be furnished by the physician providing renal care or by another physician). Example: Medical management of diabetes mellitus unrelated to dialysis or furnished during a dialysis session may be submitted separately.
  • Covered physician services to hospital inpatients, including services related to inpatient dialysis, by a physician who elects not to continue to receive MCP during the period of inpatient stay. Physician receives a prorated MCP for that month.
  • All physician services prior to initiation of outpatient dialysis
  • Covered physician services furnished by another physician when the patient is not able to receive the outpatient services as usual (e.g., when the patient is traveling out of town)


last updated on 02/27/2015
ver 1.0.51