ESRD Beneficiary

ESRD Beneficiary means a beneficiary who meets either of the following:
(1) Is receiving dialysis or other services for end-stage renal disease, up to and including the month in which the beneficiary receives a kidney transplant up to and including the month in which the beneficiary receives a kidney transplant.
(2) Has already received a kidney transplant and has a non-AKI dialysis or MCP claim—
(i) At least 12 months after the beneficiary's latest transplant date; or
(ii) Less than 12 months after the beneficiary's latest transplant date and has a kidney transplant failure diagnosis code documented on any Medicare claim.

Source

42 CFR § 512.310

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Scoping language

For purposes of this subpart, the following definitions apply.

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