Dialysis and Transplant Bills: Medicare Costs and Payments

Adapted from Medicare Coverage of Kidney Dialysis and Kidney Transplant Services, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Costs & payments

What does Medicare cost?

Medicare Part A (Hospital Insurance) costs

Most people don’t pay a monthly premium for Part A because they (or a spouse) paid Medicare taxes while they were working.

Medicare Part B (Medical Insurance) costs

Most people must pay a monthly premium for Part B. The standard Part B premium for 2025 is $185 per month, although it may be higher based on your income. Premium rates can change yearly.

You need Part B to get full ESRD benefits, including regular dialysis, and you must pay the Part B premium. For more information about the Part B premium, visit SSA.gov.

Note: If you choose to join a Medicare Advantage Plan, you may have different or additional costs based on your plan. For more information on costs, contact your plan for specific costs information.

What does Medicare pay for dialysis services?

Medicare pays your dialysis facility to give you these Part B-covered dialysis services and items:

• Direct nursing services including: registered nurses, licensed practical nurses, technicians, social workers, and dietitians
• All equipment and supplies used for kidney dialysis in the facility, or in your home, that are reasonable and medically necessary
• Injectable, intravenous (IV), and certain oral drugs that treat or manage conditions associated with ESRD (like anemia) or are used in the treatment of ESRD
• Laboratory tests
• Home dialysis training by a Medicare-certified home dialysis training facility (if you choose to get dialysis at home)
• Other items and services, like heart monitoring during your dialysis treatments, oxygen given (if needed) during your dialysis treatments (if you’re in a dialysis facility), monitoring of your access site, and certain nutritional services

Your dialysis facility must give you these items and services directly, or through an arrangement with another provider.

Important note for people taking calcimimetics or phosphate binders:

Medicare Part B covers oral medications under the ESRD payment system, which includes oral calcimimetics and phosphate binders. Calcimimetic medications include the intravenous medication Parsabiv, and the oral medication Sensipar. Generic versions of Sensipar are available. Phosphate binders include all commercially available oral phosphate binders, including generics.

In addition to the calcimimetics and phosphate binders, the ESRD payment system includes payment for new and innovative drugs and biological products, including KORSUVA™ (difelikefalin) injection for the treatment of pruritis (itching) and VAFSEO® (Vadadustat) tablets, for oral use, for the treatment of anemia.

Your dialysis facility is responsible for giving you these medications. They can give them to you at their facility, or through a pharmacy they work with. You’ll have a 20% coinsurance for these medications. If you’re in a Medicare Advantage Plan, your costs and coverage for you and your living donors will be (or are) different and plan-specific.

You’ll need to work with your dialysis facility and your doctor to find out where you’ll get these medications, and how much you’ll pay. Talk with your doctor or health care team about the use of any drugs, including over-the-counter products.

What will I pay for dialysis services in a dialysis facility?

If you have Original Medicare, after you pay the Part B yearly deductible, you’ll continue to pay a 20% coinsurance of the Medicare-approved amount for all covered dialysis-related services. Medicare will pay the remaining 80%.

The dollar amount of your coinsurance may vary. If you’re in a Medicare Advantage Plan or have a Medicare Supplement Insurance (Medigap) policy (page 30) that covers all or part of your 20% coinsurance, then your costs may be different. Read your plan materials, or call your benefits administrator to get your cost information. You must also continue to pay your monthly Medicare Part B and Medicare Part D drug coverage premiums (if applicable).

Note: Your 20% coinsurance covers all of the services and items listed on page 12. Since the bundled payment system includes these services and items, you can’t be billed separately for them. You also don’t need to get the drugs that are included in the bundle from your Medicare Part D plan (if you have one).

What will I pay for dialysis in a hospital?

If you’re admitted to a hospital and get dialysis, Part A will cover your treatments as part of the cost of your covered inpatient hospital stay.

• Inpatient doctors’ services In Original Medicare, your kidney doctor bills separately for the Medicare-covered ESRD services you get as an inpatient. In this case, your kidney doctor’s monthly payment will be based on the number of days you stay in the hospital.
• Outpatient doctors’ services Original Medicare pays most kidney doctors a monthly amount. In some cases, your doctor may be paid per day if you get services for less than one month. After you pay the Part B yearly deductible ($283 in 2026). Medicare pays 80% of the monthly amount. You pay the remaining 20% coinsurance.

Example: Let’s say the monthly amount that Medicare pays your doctor for each dialysis patient is $125. After you pay the Part B yearly deductible, here are the costs:

• Medicare pays 80% of the $125 (or $100).
• You pay the remaining 20% coinsurance (or $25).

Remember, what you pay may be different than what’s shown in this example.

What will I pay for home dialysis training services?

Original Medicare pays your kidney doctor a fee to supervise home dialysis training. After you pay the Part B yearly deductible ($283 in 2026), Medicare pays 80% of the fee and you pay the remaining 20%.

Example: Let’s say the fee for the kidney doctor who’s supervising your home dialysis training is $500. After you pay the Part B yearly deductible, here are the costs:

• Medicare pays 80% of the $500 (or $400).
• You pay the remaining 20% coinsurance (or $100).

Remember, what you pay may be different than what’s shown in this example.

What will I pay for my child who has ESRD?

If you have a child under 18 who has Medicare because of ESRD, the payment rules are the same as described above. However, the rates paid to dialysis facilities are increased by 30% and adjusted based on the child’s age and the type of dialysis they get. These adjustments allow for the special care needs of children. Your 20% coinsurance will be based on these special rates.

Visit Medicare.gov/basics/children-and-end-stage-renal-disease for more information on Medicare coverage for children with ESRD.

What Medicare pays for transplant services

The amounts listed in this section are for transplant services that Original Medicare covers. If you’re in a Medicare Advantage Plan, your costs may be different. Read your plan materials, or call your plan to get information about your costs.

What do I have to pay for my kidney donor?

Medicare will pay the full cost of care for your kidney donor. You don’t have to pay a deductible, coinsurance, or other costs for your donor’s hospital stay. Also, your kidney donor doesn’t have to pay a deductible, coinsurance, or any other costs for their hospital stay.

What do I have to pay for hospital services?

If you have Original Medicare, in 2026, you pay:

• $1,736 deductible per benefit period
• Days 1–60: $0 coinsurance for each benefit period
• Days 61–90: $434 coinsurance per day of each benefit period
• Days 91 and beyond: $868 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
• Beyond lifetime reserve days: all costs

Lifetime reserve days are additional days that Medicare will pay for when you’re in a hospital for more than 90 days. You have a total of 60 reserve days that you can use during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance.

For Medicare-approved care in a skilled nursing facility, you pay:

• Days 1–20: $0 for each benefit period
• Days 21–100: $217 coinsurance per day of each benefit period
• Days 101 and beyond: You pay all costs

To find out what you’ll pay for other Medicare Part A and Medicare Part B services, visit Medicare.gov/basics/costs, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

What do I have to pay for doctors’ services?

In Original Medicare, you pay the Medicare Part B yearly deductible ($283). After you pay the deductible, Medicare pays 80% of the Medicare-approved amount. You pay the remaining 20% coinsurance.

Important: There’s a limit on the amount your doctor can charge you, even if your doctor doesn’t accept assignment. If your doctor doesn’t accept assignment, you only have to pay the part of the bill that’s up to 15% over the Medicare-approved amount.

What do I have to pay for clinical laboratory services?

You pay nothing for Medicare-approved laboratory tests. These services are included in the amount you pay for your dialysis treatment.

What Medicare pays for blood services

In most cases, Medicare Part A and Medicare Part B help pay for:

• Whole blood units or packed red blood cells
• Blood components
• The cost of processing and giving you blood

What do I pay for blood services?

Under both Part A and Part B, in most cases, the hospital gets blood from a blood bank at no charge, and you won’t have to pay for it or replace it. If the hospital has to buy blood for you, you must either pay the hospital for the first 3 units of whole blood or equivalent units of packed red blood cells that you get in a calendar year (while you’re staying in a hospital or skilled nursing facility), or replace the blood.

You pay a copayment for additional units of blood you get as an outpatient (after the first 3), and the Part B deductible applies.

Note: Once you’ve paid for or replaced the required units of blood, you don’t have to do so again under either Part A or Part B for the remainder of the calendar year.

Donating blood

You can replace the blood by donating it yourself or getting another person or organization to donate the blood for you. The blood that’s donated doesn’t have to match your blood type. If you decide to donate the blood yourself, check with your doctor first.

You can’t be charged for blood that you’ve already donated. A hospital or skilled nursing facility can’t charge you for any of the first 3 pints of blood you’ve already donated or will donate in the future.

Note: Medicare doesn’t pay for blood as part of home dialysis unless it’s part of a doctor’s service or is needed to prime the dialysis equipment.

Source and further reading

Medicare Coverage of Kidney Dialysis and Kidney Transplant Services — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.