MedicaidBilling CodesHigh impact
New York Medicaid: Dialysis treatment reimbursements include phosphate binders
UnitedHealthcare·NY · Nephrology·State news
Effective date
Jan 1, 2026
We identified it
Feb 1, 2026
Summary
Effective January 1, 2026, New York Medicaid now includes phosphate binders in the bundled Ambulatory Patient Group (APG) reimbursement for dialysis services. Providers must submit only one claim for dialysis services and cannot bill separately for phosphate binders, as separate claims will be denied.
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 during dialysis sessions. Update billing system rules and staff training to prevent separate phosphate binder claims, as these will be denied as non-covered services.