MedicaidReimbursementHigh impact
New York Medicaid: Dialysis treatment reimbursements include phosphate binders
UnitedHealthcare·NY · Nephrology·State news
Effective date
Jan 1, 2026
We identified it
Jun 13, 2026
Summary
Effective January 1, 2026, New York Medicaid now includes phosphate binder costs in dialysis 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 binder coverage. Stop submitting separate claims for phosphate binders used in dialysis services as these will be denied as non-covered. Update billing software rules and train staff that phosphate binder costs are now bundled in APG reimbursement for NY Medicaid patients.