UnitedHealthcareHigh ImpactBilling Codes

New York Medicaid: Dialysis treatment reimbursements include phosphate binders

Published February 1, 2026Effective January 1, 2026

AI 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.

Plan Types

Medicaid

States

NY

Specialties

nephrology