Maintenance dialysis may be provided in a hospital on an outpatient basis or in a provider or nonprovider operated limited care facility, or, rarely, in an SNF; any of these may be a “self-care” unit. The term “limited care facility” generally refers to an offhospital-premises facility, regardless of whether it is provider or nonprovider operated, which is engaged primarily in furnishing maintenance dialysis services to stabilized patients.

Patients who receive home dialysis treatments are reimbursed under the reasonable charge criteria for durable medical equipment and supplies obtained from suppliers other than provider facilities. (See HI 00610.200) Payment may also be made for home dialysis supplies and equipment as a separate benefit.

A variety of contractual arrangements may be entered into by the patient for the leasing or purchase of a dialysis machine and the delivery of disposable supplies. Most are generally acceptable under presently applicable criteria. Some contracts provide arrangements whereby all supplies are furnished through the designated facility in the locality that is to provide support services to home dialysis patients. If the suppliers and the designated facility agree to have the supplies routed through the facility, the reimbursement for the necessary supplies will be made by the intermediary servicing the provider facility—on a reasonable cost basis.