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CMS-1403-FC
physician or practitioner who furnishes renal care or by
another physician or practitioner. These are services that
are not incidental to services furnished during a dialysis
session or office visits necessitated by the renal
condition. The physician or practitioner must provide
documentation that the illness is not related to the renal
condition and that the additional visits are medically
necessary. The Medicare contractor’s medical staff
determines whether additional reimbursement is warranted
for treatment of the unrelated illness. Medicare does not
pay separately for ESRD-related services furnished via
telehealth that are covered by the MCP. (See the CMS
Internet-Only Medicare Claims Processing Manual, Pub.
100-04, Chapter 8, Section 140, for more information on
Medicare policy regarding the monthly capitation payment
method for physicians’ services.)
Community Mental Health Centers
Section 149 of the MIPPA added community mental health
centers (CMHCs), as defined in section 1861(ff)(3)(B) of
the Act, to the list of originating sites for Medicare
telehealth services. The Medicare statute recognizes CMHCs
as “providers of services” for purposes of furnishing
partial hospitalization programs (PHP). PHPs are
structured and intensive programs consisting of a group of
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