Your Medicare Coverage

Is my test, item, or service covered?

Kidney disease education

How often is it covered?

Medicare covers up to 6 sessions of kidney disease education to help you delay the need for a kidney transplant or dialysis and prevent kidney disease complications. Doctors, physician assistants, nurse practitioners, and clinical nurse specialists can offer these services. 

Kidney disease education teaches you how to take the best possible care of your kidneys and gives you information you need to make informed decisions about your care. You'll learn about these topics:

  1. How to manage health conditions like heart disease, diabetes, high blood pressure, and anemia
  2. How your kidneys work
  3. What you should and shouldn’t eat
  4. How your medications work
  5. Your treatment options if your kidneys get worse:
    • Kidney transplant  
    • Hemodialysis
    • Peritoneal dialysis
    • Access options for hemodialysis and peritoneal dialysis

You can also ask about these topics:

  • How you’ll feel
  • How to maintain your kidney function
  • Exercise
  • What your test results mean
  • Your family and social life
  • Work and finances
  • Your mental health
  • Your right to to choose not to get a kidney transplant or dialysis

Who's eligible?

People with Medicare Part B (Medical Insurance) who have Stage IV chronic kidney disease (CKD). The doctor who manages your kidney disease must give you a referral for these services.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount per session if you get the service from a doctor or other qualified health care provider, and the Part B deductible applies.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

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