The Centers for Medicare and Medicaid (CMS) pays a significantly higher rate for End Stage Renal Disease (ESRD) patients compared to Aged and Disabled (A&D) patients. In the Pearl Platform, you can log in and see your payment rates for your A&D and ESRD patients. Below are the steps on how to do so:

1. Log into https://app.pearlhealth.com/login/.

2. Click on the Financials tab on the top of the page.

3. On the Statements screen, download the CSV or PDF file next to any statement.

4. In the CSV or PDF file, look under the Type and PBPM column to view the patient type and PBPM amount corresponding to that patient.

Rather than being driven by the CPT codes that you bill, Medicare considers a patient in ESRD if a regular course of dialysis has been prescribed by a physician when the person has reached that stage of renal impairment, or where a kidney transplant is necessary to maintain life.

Note: If a kidney graft works, the patient can move back to A&D from ESRD.