[Code of Federal Regulations] [Title 42, Volume 2] [Revised as of October 1, 2002] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR413.182] [Page 607] TITLE 42--PUBLIC HEALTH HUMAN SERVICES PART 413--PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES--Table of Contents Subpart H--Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs Sec. 413.182 Criteria for approval of exception requests. CMS may approve exceptions to an ESRD facility's prospective payment rate if the facility demonstrates, by convincing objective evidence, that its total per treatment costs are reasonable and allowable under the relevant cost reimbursement principles of part 413 and that its per treatment costs in excess of its payment rate are directly attributable to any of the following criteria: (a) Atypical service intensity (patient mix), as specified in Sec. 413.184. (b) Isolated essential facility, as specified in Sec. 413.186. (c) Extraordinary circumstances, as specified in Sec. 413.188. (d) Self-dialysis training costs, as specified in Sec. 413.190. (e) Frequency of dialysis, as specified in Sec. 413.192.