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<strong>CMS</strong>-1403-FC<br />

required to furnish directly, and for which payment is<br />

included in the case-mix adjusted composite rate, we will<br />

not pay separately for the services of clinical social<br />

workers (CSW), registered dietitians, and nutrition<br />

professionals furnished via telehealth to ESRD outpatients<br />

in renal dialysis centers.<br />

Physicians and practitioners managing ESRD facility<br />

patients are paid a monthly rate (the MCP) for most<br />

outpatient maintenance dialysis-related physician services<br />

furnished to a Medicare ESRD beneficiary. The MCP amount<br />

varies based on the number of visits provided within each<br />

month and the age of the ESRD beneficiary.<br />

When the MCP is billed for ESRD-related services with<br />

2 or 3 visits per month or for ESRD-related services with 4<br />

or more visits per month, some of the visits may be<br />

furnished as a telehealth service. However, at least one<br />

visit per month is required to be furnished by the<br />

physician or practitioner in person to examine the vascular<br />

access site. A clinical examination of the vascular access<br />

site must be furnished once per month face-to-face (not as<br />

a telehealth service) by a physician, nurse practitioner,<br />

or physician’s assistant.<br />

Consistent with existing policy, non-ESRD-related<br />

physicians’ services may be furnished via telehealth by the<br />

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