New York Medicaid: Dialysis treatment reimbursements include phosphate binders

Submit only 1 claim for the bundled service

Effective Jan. 1, 2026, the cost for phosphate binders used in dialysis sessions for UnitedHealthcare Community Plan members is included in Ambulatory Patient Group (APG) reimbursement payments. This change aligns with the October 2025 New York State Medicaid Update  published by the Department of Health.

What this means for you

Adjustments will be made to the appropriate tax identification number (TIN) for all applicable claims already paid with dates of services on or after Jan. 1, 2026. 

When submitting claims for dialysis services:

• Submit only 1 claim for dialysis services. Your reimbursement will include coverage for the phosphate binders.
• Do not submit a separate claim for phosphate binders used in dialysis services. The claim will be denied as a non-covered service.