ESRD

Published

March 30, 2026

Facility Ranges

The last four characters of a Provider CCN represent the facility type and a unique identifier. The facility type is encoded in the third character of the last four characters. The table below summarizes the valid facility type codes and their corresponding ranges.

range abbr desc
0001-0879 STC Short-Term Hospital (General & Specialty)
2000-2299 LTCH Long-Term Care Hospital
2300-2499 ESRD Hospital-based Renal Dialysis Facility
2500-2899 ESRD Independent Renal Dialysis Facility
2900-2999 ESRD Independent Special Purpose Renal Dialysis Facility
3300-3399 CH Children's Hospital
3500-3699 ESRD Hospital-based Satellite Renal Dialysis Facility
3700-3799 ESRD Hospital-based Special Purpose Renal Dialysis Facility

Details

  1. Hospital-Based Renal Dialysis Facilities, [2300, 2499]: The physical location of an ESRD facility on the premises of a hospital is not considered when determining if the ESRD facility is hospital-based. Hospital corporate control is a critical factor in determining whether an ESRD facility is hospital-based. Hospitals may have a lease arrangement for the management of a hospital-based ESRD facility by a non-hospital manager. This CCN range is used for ESRD facilities that have been determined by the CMS to be hospital-owned, hospital-administered ESRD facilities physically located on the hospital’s premises as opposed to independent ESRD facilities and Hospital-Based Renal Disease Satellite Facilities. The satellites are hospital-based, but are physically located off the hospital’s premises.

  2. Hospital-Based Renal Dialysis Satellite Facilities, [3500, 3699]: This CCN range is used for those ESRD facilities that are hospital-owned and hospital-administered, but that are not located on the hospital’s premises. This is why they are referred to as hospital-based satellites. In determining whether such a satellite facility is hospital-based, use the same criteria as you would in making a hospital-based determination under the 2300-2499 series, except that you would assign a 3500-3699 number to such a facility because it is off the premises of the hospital to which it is based. The word “premises” is not explicitly defined in the statute, regulations, or State Operations Manual, but there is a definition of “furnishes on the premises” that states “the ESRD facility furnishes services on its main premises; or its other premises that are:

    1. Contiguous with or in immediate proximity to the main premises, and under the direction of the same professional staff and governing body as the main premises, or
    2. Approved on a time-limited basis as a special purpose renal dialysis facility.”

Thus, in addition to the regulations, which should assist you in determining whether the facility is an integral part of the hospital, you may use the “furnishes on the premises” definition to distinguish between a hospital-based entity under the 2300-2499 series as opposed to an entity under the 3500-3699 number series.

Also, we do not believe that these satellites will be furnishing inpatient dialysis services. The CMS will make or approve the determination that a particular ESRD facility meets the requirements to be hospital-based, and if it is off the hospital’s premises, a hospital-based satellite. It is conceivable that a hospital-based ESRD facility could have a 2300-2499 number assigned to the location on the hospital’s premises, and one or more 3500-3699 numbers for those locations (satellites) off the premises (each satellite is given a separate 3500- 3699 number). If an ESRD facility that is assigned a 2300-2499 number moves off the hospital’s premises and is determined to be a satellite, it should receive a number in the 3500-3699 series. However, if a satellite changes its address but is still considered off the hospital’s premises, it should retain the 3500-3699 number it was originally issued rather than being issued a new 3500-3699 number. Any questions concerning billing should be referred to the RO financial component or the fiscal intermediary as you determine appropriate.

Note

In determining whether an entity is hospital-based for reimbursement purposes, the requirements at §2287 must be met.

  1. Hospital-Based Special Purpose Renal Dialysis Facilities, [3700, 3799]: In order to be classified as a Hospital-Based Special Purpose Renal Dialysis Facility and issued a number under the 3700-3799 series, an ESRD facility must be determined to be hospital-based, and meet the definition at 42 CFR 405.2102, and the requirements at 42 CFR 405.2164 for such a facility. A facility under this category should bill Medicare under the CCN of the hospital to which it is based. There should be very few of these facilities.

  2. Independent Renal Dialysis Facilities, [2500, 2899]: Independent Renal Dialysis Facilities, issued a number under the 2500-2899 series, are independent ESRD facilities. These facilities do not meet the definition of hospital-based irrespective of whether they are located on or off the hospital’s premises. A determination of independent, as opposed to hospital-based, will be based on the statutory and regulatory provisions and manual instructions. Independent facilities bill under their own numbers. ESRD facilities located at skilled nursing facilities will be determined to be independent.

  3. Independent Special Purpose Renal Dialysis Facilities, [2900, 2999]: The same requirements that apply to a Hospital-Based Special Purpose Renal Dialysis Facility apply to a facility of the same type which is independent except that the independent facility by virtue of its independent status, bills under its own number which is in the 2900-2999 series.

  4. Other: When an ESRD facility proposes to change from hospital-based to independent or vice-versa, an onsite survey is not necessary unless there is a physical relocation of the facility. However, a determination as to the proper facility definition and if necessary, the changing of the number designation, must be made in accordance with the guidance described here and in §2287. If an ESRD facility proposes to add a location that has not been previously surveyed, an onsite inspection would be required. In the absence of an onsite survey and certification, the proposed facility has no authority to bill Medicare for ESRD services provided at the proposed site. (See §3222.) There are some instances when an ESRD facility’s CCN requires a change as a result of an action taken by the ESRD facility. If a hospital-based facility converts to an independent ESRD facility or if an independent ESRD facility converts to a hospital-based ESRD facility, there must be a CCN change. Satellite ESRD facilities must be hospital owned and are considered hospital-based. A hospital may have more than one ESRD satellite facility.

The CCN of the ESRD facility may remain the same in the following situations:

  • A hospital-based ESRD facility retains ownership of the facility but contracts with another entity for management of the facility;
  • The hospital closes the dialysis facility but retains its transplant program. The CMS terminates the outpatient dialysis services but retains the ESRD CCN for the still active transplant program;
  • The hospital closes the transplant program but retains the ESRD facility. In such case, CMS terminates the transplant program but keeps the ESRD CCN active for the dialysis program;
  • The ESRD facility is purchased by another ESRD facility of the same type. For example, independent by independent or hospital-based by hospital-based; and
  • The geographic location of the ESRD facility is changed within the same state. A recertification survey is always required when a dialysis facility relocates within a state. If a geographic location is changed to another state, the ESRD facility at the old location must be terminated and the relocated ESRD facility must qualify as a new applicant with a new identification number in the state to which it moved.

Examples

esrd <- ccn:::get_pin("esrd")
esrd
# A tibble: 7,561 × 8
   ccn    state facility_name                    chain profit office  peri  home
   <chr>  <chr> <chr>                            <chr> <chr>   <int> <int> <int>
 1 012306 AL    CHILDRENS HOSPITAL DIALYSIS      Inde… N           1     1     1
 2 012500 AL    FMC CAPITOL CITY                 Fres… P           1     1     1
 3 012501 AL    DaVita Gadsden Dialysis          DaVi… P           1     0     0
 4 012502 AL    DaVita Tuscaloosa University Di… DaVi… P           1     1     0
 5 012505 AL    DaVita PDI-Montgomery            DaVi… P           1     1     1
 6 012506 AL    DaVita Dothan Dialysis           DaVi… P           1     1     1
 7 012507 AL    FMC MOBILE                       Fres… P           1     0     0
 8 012508 AL    DaVita Birmingham East Dialysis  DaVi… P           1     0     0
 9 012512 AL    FMC SELMA                        Fres… P           1     0     0
10 012513 AL    BMA LANGDALE                     Fres… P           1     0     0
# ℹ 7,551 more rows

Overview

over <- cheapr::overview(esrd)

over$numeric |> 
   fastplyr::as_tbl() |>
   collapse::slt(col, unique = n_unique, mean, sd, p0:iqr, hist) |>
   gt::gt() |> 
   gt_chamber_theme() |>
   gt::tab_options(quarto.disable_processing = TRUE) |> 
   gt::fmt_number(columns = c(mean, sd))
col unique mean sd p0 p25 p50 p75 p100 iqr hist
office 2 0.93 0.25 0 1 1 1 1 0 ▁▁▁▁▇
peri 2 0.54 0.50 0 0 1 1 1 1 ▇▁▁▁▇
home 2 0.32 0.46 0 0 0 1 1 1 ▇▁▁▁▃ 
over$categorical |> 
   fastplyr::as_tbl() |>
   collapse::slt(col, unique = n_unique, min, max) |>
   collapse::mtt(
      min = stringr::str_wrap(min, width = 40), 
      max = stringr::str_wrap(max, width = 40)) |>
   gt::gt(process_md = TRUE) |> 
   gt_chamber_theme() |>
   gt::tab_options(quarto.disable_processing = TRUE) |> 
   gt::cols_align("left", c(min, max)) |> 
   gt::cols_align("right", c(col))
col unique min max
ccn 7561 012306 852609
state 56 AK WY
facility_name 7550 032314 PHOENIX CHILDRENS HOSPITAL- DIALYSIS CENTER zz_closed_DIALYSIS CARE CENTER TIPTON COUNTY LLC
chain 32 American Renal Associates Wake Forest University
profit 2 N P

Counts

df <- purrr::map(esrd$ccn, ccn::as_data_frame) |> 
  data.table::rbindlist()

df |>
  collapse::fcount(type, range) |>
  collapse::roworder(-N) |>
  gt::gt() |>
  gt::tab_options(quarto.disable_processing = TRUE) |>
  gtExtras::gt_theme_nytimes() |>
  gt::tab_style(
    style = gt::cell_text(
      font = gt::google_font(name = "JetBrains Mono"),
      color = "grey60",
      size = "small"
    ),
    locations = gt::cells_body(columns = range)
  ) |>
  gt::tab_style(
    style = gt::cell_text(
       color = "grey40", 
       weight = "bold",
       size = "small",
       font = gt::google_font(name = "JetBrains Mono")
       ),
    locations = gt::cells_body(columns = type)
  )
type range N
ESRD (Independent Renal Dialysis Facility) 2500-2899 7206
ESRD (Hospital-based Renal Dialysis Facility) 2300-2499 214
ESRD (Hospital-based Satellite Renal Dialysis Facility) 3500-3699 139
ESRD (Independent Special Purpose Renal Dialysis Facility) 2900-2999 1
ESRD (Hospital-based Special Purpose Renal Dialysis Facility) 3700-3799 1