Home dialysis equipment is all equipment, supplies and support services, and certain drugs and biologicals which are required to effectively perform dialysis in the home. This includes instruments and non-medical supplies [e.g., scales, blood pressure cuffs, stop watches, stethoscope, heating pad for peritoneal dialysis, etc.] and disposable supplies [e.g., alcohol wipes, sterile drapes, etc.]

Home use of dialysis equipment, supplies, and selected medications may be considered medically necessary when the individual has a diagnosis of end-stage renal disease (ESRD). 

All other uses of home dialysis equipment, supplies and selected medications will be considered not medically necessary.

An exception to the general coverage of all dialysis supplies is the “Patient Aid,” a device used to train dialysis patients in correcting alarm conditions.  These devices are considered not medically necessary.

The instruments and non-medical supplies must either be purchased or provided as part of the actual dialysis equipment and included in the overall charge for such equipment. (Coverage does not extend to the rental of these items separately. Claims submitted for rental of the instruments/non-medical equipment (as separate units) will be denied. Disposable supplies are covered as separate items.)

Total payments for a rental item may not exceed its allowable purchase price, except for those items identified as life sustaining DME.

Shipping charges for home dialysis supplies are covered.

See Medical Policy Bulletin E-1 for guidelines on Thermometers.

Home dialysis equipment and supplies are typically used on an outpatient basis which are only eligible for coverage on an inpatient basis in special circumstances, including, but not limited to, the presence of a co-morbid condition that would require monitoring in a more controlled environment such as the inpatient setting.