New York Medicaid: Dialysis treatment reimbursements include phosphate binders
AI Summary
Effective January 1, 2026, New York Medicaid now includes phosphate binder costs in dialysis Ambulatory Patient Group (APG) reimbursement payments for UnitedHealthcare Community Plan members. Providers must submit only one claim for dialysis services and cannot bill separately for phosphate binders used during dialysis sessions.
Action Required
Immediately: Billing team must update dialysis billing procedures to submit only one claim for dialysis services that includes phosphate binders. Stop submitting separate claims for phosphate binders used in dialysis services as these will be denied as non-covered. Update billing software rules and staff training to prevent duplicate billing for New York Medicaid UnitedHealthcare Community Plan members.
Plan Types
Medicaid
States
NY
Specialties
nephrology