TMPPM 2008 > Texas Medicaid Services > Renal Dialysis Facility > Benefits and Limitations

40.3.4 Laboratory and Radiology Services

40.3.4.1 In-Facility Dialysis-Routine Laboratory

Laboratory services may be performed in the CRD facility or by an outside laboratory. Charges for routine laboratory tests performed according to the established frequencies in the following tables are included in the facility's dialysis charge billed to Medicaid regardless of where tests were performed. Routine laboratory services performed by an outside laboratory are billed to the facility.

Per Dialysis

Per Week

Per Month

The routine tests listed in the tables above are frequently performed as an automated battery of tests such as the SMAC-12. These tests are considered routine and are included in the charge for dialysis, unless there is an additional diagnosis to document medical necessity for performing the tests in excess of the recommended frequencies.

If it is medically necessary to perform a routine laboratory test beyond the established frequency, payment may be made if the test is indicated on the claim form along with documentation of medical necessity.

Refer to: "Laboratory Paneling" for more information about laboratory paneling procedures.