It is important to note that Medicare does not apply originating site geographic conditions to hospital-based and CAH-based
renal dialysis centers, renal dialysis facilities, and beneficiary homes when practitioners furnish monthly home dialysis
ESRD-related medical evaluations. Independent Renal Dialysis Facilities are not eligible originating sites. A physician, NP, PA,
or CNS must furnish at least one ESRD-related “hands-on visit” (not telehealth) each month to examine the beneficiary’s
vascular access site.
Distance Site Practitioners
Distant site practitioners who can furnish and get payment for covered telehealth services (subject to State law) are:
• Nurse practitioners (NPs)
• Physician assistants (PAs)
• Clinical nurse specialists (CNSs)
• Certified registered nurse anesthetists
• Clinical psychologists (CPs) and clinical social workers (CSWs)
• Registered dietitians or nutrition professional.