Every plate carries its sources in the margin; this page gathers them into one ledger—what each work is, where it appears in the atlas, how it was verified, and when its link was last checked. When this atlas and a primary source disagree, the primary source wins. Always.
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| 42 CFR Part 494 (§§ 494.20-494.180) | The Conditions for Coverage for ESRD facilities—the federal floor, and the text the frontispiece is drawn from | The Crossroads · The Border · The Transplant Map · The Crosswalk · The Accumulation · The Two Ladders · The Benchmark Pipeline · The Draws · The Data Map · The Regulatory Year-Wheel · the frontispiece · the essay | Primary text held in the workshop | eCFR ↗ | 2026-07-14 |
| 42 CFR 413.178 | The ESRD Quality Incentive Program’s payment authority | The Accumulation · The Benchmark Pipeline · The Coverage Map · The Data Map | Primary read at the source | eCFR ↗ | 2026-07-10 |
| 42 CFR 413.234 | Drug designation: TDAPA—how a new drug enters the bundle | The Accumulation · The Coverage Map | Primary read at the source | eCFR ↗ | 2026-07-10 |
| 42 CFR 413.236 | Equipment and supplies: TPNIES—the add-on for new dialysis equipment and supplies | The Accumulation · The Coverage Map | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR 406.13 | ESRD Medicare entitlement—the calendar-month waiting period, and the home-training waiver that shortens it | The Coverage Map | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR 411.162 | The 30-month coordination period—when an employer group health plan pays primary to Medicare for ESRD | The Coverage Map | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR 422.214 | Medicare Advantage payment to non-contract providers—the mechanic that benchmarks MA dialysis payment to the PPS | The Coverage Map | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR Part 482 | The hospital Conditions of Participation—the law that governs acute inpatient dialysis, where the ESRD Conditions do not reach | The Border | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR 413.174 | Payment for acute dialysis furnished to inpatients—bundled in the MS-DRG, not the ESRD PPS | The Border | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR 405.2112(f) | The ESRD Network’s annual report to CMS—the July 1 deadline on the year-wheel | The Regulatory Year-Wheel | Primary read at the source | eCFR ↗ | 2026-07-14 |
| 42 CFR Part 488 | The survey, certification, and enforcement framework—incl. deemed status, by which an accreditor’s survey stands in for the State agency’s | The Border | Primary read at the source | eCFR ↗ | 2026-07-14 |
| Social Security Act § 1881(b)(7) | The statute behind the 50-cent-per-treatment ESRD Network withhold—the authority, distinct from the QIP’s | The Accumulation · The Money Flow | Primary read at the source | SSA ↗ | 2026-07-14 |
| Trade Preferences Extension Act of 2015, sec. 808(a) | Opened certified ESRD facilities to acute kidney injury patients (effective Jan 1, 2017) | The Border · The Accumulation | Primary read at the source | govinfo ↗ | 2026-07-14 |
| 21st Century Cures Act, sec. 17006 | Opened Medicare Advantage enrollment to ESRD beneficiaries, effective January 1, 2021 | The Accumulation · The Coverage Map | Primary read at the source | govinfo ↗ | 2026-07-14 |
| Public Law 95-292 (June 13, 1978) | The act that built the ESRD program’s oversight frame—amending SSA titles II and XVIII; the ESRD Networks trace here | The Accumulation | Primary read at the source | govinfo ↗ | 2026-07-26 |
| Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), sec. 153 | The authority for the first federal value-based purchasing program in Medicare—the ESRD QIP, codified at SSA sec. 1881(h) | The Accumulation | Primary read at the source | govinfo ↗ | 2026-07-26 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| CMS ESRD Program Interpretive Guidance v1.1 (S&C-09-01, October 2008) | The V-tag text and the Measures Assessment Tool—the substantive interpretive corpus behind the survey | The Transplant Map · The Crosswalk · The Accumulation · The Two Ladders · The Draws | Primary text held in the workshop | CMS ↗ | 2026-07-10 |
| CDC MMWR 2001;50(RR-05)—Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients | Incorporated by reference at 42 CFR 494.30(a)(1)(i)—except screening for hepatitis C. This is the document the hepatitis B calendar actually comes from, and it is written for chronic hemodialysis | The Draws | Primary read at the source | CDC ↗ | 2026-07-14 |
| State Operations Manual, Appendix H | Where the ESRD interpretive guidance and survey protocol now live—relocated by memo QSO-26-09-ESRD (May 2026) | The Border · The Crosswalk · The Accumulation | Primary text held in the workshop | CMS ↗ | 2026-07-25 |
| State Operations Manual, Appendix Z (Emergency Preparedness) | The E-tag survey guidance for the 2016 Emergency Preparedness rule—why 494.62 is scored outside the V-tag series | The Crosswalk · The Accumulation | Via secondary summary—no primary artifact | CMS ↗ | 2026-07-14 |
| CMS SOM—CCN methodology (Transmittal R29SOMA) | The CMS Certification Number blocks—incl. the hospital-based chronic renal block (2300-2499) that marks a separately certified hospital unit | The Border | Primary read at the source | CMS ↗ | 2026-07-14 |
| CMS S&C Letter 17-02 (ESRD Core Survey) | The ESRD Core Survey materials—the memo documenting that surveyors' presurvey prep reviews the Dialysis Facility Report and sets data-driven focus areas | The Accumulation · The Data Map | Primary read at the source | CMS ↗ | 2026-07-14 |
| MLN Matters MM14313—ESRD & AKI Dialysis: CY2026 Update | The CY2026 payment-update article: no TPNIES-eligible items for CY2026, and the phosphate-binder TDAPA ($36.41 per monthly claim) continuing through CY2026 | The Coverage Map | Primary read at the source | CMS ↗ | 2026-07-14 |
| FDA Drug Safety Communication—ESA dosing in chronic kidney disease (June 24, 2011) | The label change that removed the 10-12 g/dL hemoglobin target range: dose to the lowest level sufficient to reduce the need for transfusions | The Accumulation · The Benchmark Pipeline | Primary read at the source | web.archive.org ↗ | 2026-07-14 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| CY2026 ESRD PPS Final Rule (CMS-1830-F) | The year’s payment rule—base rate, QIP updates, AKI rate; published in the Federal Register November 24, 2025 | The Accumulation · The Benchmark Pipeline · The Money Flow · The Coverage Map · The Regulatory Year-Wheel | Primary read at the source | Federal Register ↗ | 2026-07-10 |
| CMS CY2026 ESRD PPS final rule fact sheet (Nov 20, 2025) | CMS’s own summary of the CY2026 rule—the source of the $6B program-payment figure and the fact-sheet series ($6.6B / $6.0B / $6.2B) the Money Flow anchors to | The Money Flow | Primary read at the source | CMS ↗ | 2026-07-14 |
| CY2015 ESRD PPS Final Rule (79 FR 66119) | The rule that removed the hemoglobin-greater-than-12 QIP measure as topped out—the 'rule 2014' point on the benchmark arc | The Accumulation · The Benchmark Pipeline | Primary read at the source | Federal Register ↗ | 2026-07-14 |
| CY2024 ESRD PPS Final Rule (CMS-1782-F, 88 FR 76344) | The rule that established the post-TDAPA add-on payment adjustment—three more years of add-on after a drug’s TDAPA period ends | The Coverage Map | Primary read at the source | Federal Register ↗ | 2026-07-14 |
| ESRD Quality Incentive Program (CMS) | The pay-for-performance machinery—measures, scoring, payment years | The Accumulation · The Data Map | Via secondary summary—no primary artifact | CMS ↗ | 2026-07-10 |
| ESRD QIP PY2028 fact sheet | The payment-year 2028 measure roster and scoring—the roster the Two Ladders and the Time Decoder draw from | The Two Ladders · The Benchmark Pipeline | Via secondary summary—no primary artifact | CMS ↗ | 2026-07-14 |
| ESRD QIP PY2026 fact sheet | The payment-year 2026 QIP calendar—the preview window (~30 days, summer) and the Final Performance Score Certificates (~December) on the year-wheel | The Regulatory Year-Wheel | Via secondary summary—no primary artifact | CMS ↗ | 2026-07-14 |
| MedPAC reports (March 2025 · December 2025 · March 2026) | The commission’s read on dialysis payment adequacy and margins—the verified 16% all-payer and 4.5% FFS Medicare margin rates | The Money Flow | Primary read at the source | MedPAC ↗ | 2026-07-10 |
| May 2026 ESRD Network contract awards | The network-contract funding figures—carried award-by-award on the Money Flow plate; the link is the USAspending record for the exemplar award (75FCMC26F0073, ESRD Networks 1, 6 and 9) | The Money Flow | Primary read at the source | USAspending ↗ | 2026-07-14 |
| Medicare Claims Processing Manual (Pub. 100-04), Chapter 8 | The billing mechanics for ESRD claims—the monthly claim cycle the year-wheel’s billing ring is drawn from | The Regulatory Year-Wheel | Via secondary summary—no primary artifact | CMS ↗ | 2026-07-14 |
| DaVita Inc. 2024 Form 10-K | The largest dialysis organization’s own audited filing—revenue mix, commercial share, market share; a primary corporate disclosure used to model the commercial inflow | The Money Flow | Primary read at the source | SEC EDGAR ↗ | 2026-07-14 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| KDOQI Clinical Practice Guideline—Hemodialysis Adequacy (2015 Update) | The best-practice targets the floor is often mistaken for | The Crossroads · The Two Ladders | Primary read at the source | AJKD ↗ | 2026-07-14 |
| KDIGO and NKF-KDOQI (the guideline bodies) | The global guideline body and its US counterpart—who writes the clinical benchmarks, on science’s clock, before any regulator adopts them | The Benchmark Pipeline | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| ISPD—prescribing high-quality, goal-directed peritoneal dialysis (Brown et al.) | The 2020 guideline that dissolved the single PD adequacy number into the person | The Two Ladders | Primary read at the source | SAGE ↗ | 2026-07-14 |
| KDIGO Clinical Practice Guideline for Lipid Management in CKD (2013) | The lipid guideline whose own words—no routine follow-up measurement for most—The Draws quotes | The Draws | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| KDIGO CKD-MBD Guideline (2017 Update) | The mineral-and-bone guideline—the calcium / phosphate / PTH cadences the CFR never sets | The Draws | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| KDIGO Clinical Practice Guideline for Hepatitis C in CKD (2022) | The guideline-only HCV screening clock—the regulation’s own carve-out means no federal clock exists | The Draws | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| KDIGO Clinical Practice Guideline for Diabetes Management in CKD (2022) | The A1c cadence—2-4x/year, with the guideline’s own low-reliability-in-dialysis caveat | The Draws | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| KDIGO Anemia in CKD Guideline (2026) | The anemia-management cadences cited alongside the federal hemoglobin floor | The Draws | Primary read at the source | KDIGO ↗ | 2026-07-14 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| Battelle—Partnership for Quality Measurement | CMS’s consensus-based entity for measure endorsement since March 27, 2023—the seat NQF previously held | The Benchmark Pipeline | Primary read at the source | p4qm.org ↗ | 2026-07-14 |
| USRDS Annual Data Report (2025) | The national registry—incidence, prevalence, outcomes, cost | The Money Flow · The Regulatory Year-Wheel | Primary read at the source | USRDS ↗ | 2026-07-10 |
| CMS EQRS (End-Stage Renal Disease Quality Reporting System) | The federal intake system—admissions, discharges, and the 2728/2746/2744 forms; the clinical-data pipe the Data Map draws | The Data Map · The Regulatory Year-Wheel | Primary read at the source | EQRS ↗ | 2026-07-14 |
| CDC NHSN Dialysis Event Surveillance | The infection-event pipe—dialysis events report to NHSN, not EQRS | The Data Map · The Regulatory Year-Wheel | Primary read at the source | CDC ↗ | 2026-07-10 |
| UM-KECC / Dialysis Facility Reports | The University of Michigan Kidney Epidemiology and Cost Center—the contractor that builds the Dialysis Facility Reports and calculates the claims/EQRS-based measures | The Benchmark Pipeline · The Data Map | Primary read at the source | DFR ↗ | 2026-07-10 |
| OPTN Policies, Policy 8.4.A—Waiting Time (Kidney Allocation System) | How deceased-donor kidney waiting time is credited: from the dialysis-start date (backdated before listing), or from registration when GFR is 20 mL/min or less | The Transplant Map | Primary read at the source | hrsa.gov ↗ | 2026-07-15 |
| OPTN / UNOS (transplant registry) | The national transplant network’s registry—where transplant centers report waitlist and transplant data | The Stakeholder Matrix | Primary read at the source | OPTN ↗ | 2026-07-14 |
| Medicare Part B-ID immunosuppressive benefit (2023) | Lifetime immunosuppressive coverage after the 36-month cliff, if no other coverage | The Transplant Map | Primary read at the source | Medicare ↗ | 2026-07-10 |
| Medicare.gov—ESRD entitlement pages | When ESRD-only Medicare entitlement ends after a successful transplant, and re-entitlement without a new waiting period if dialysis restarts | The Transplant Map | Primary read at the source | Medicare ↗ | 2026-07-14 |
| CMS Innovation Center—ESRD Treatment Choices (ETC) Model record | The model record for the mandatory home-dialysis/transplant model (2021; terminated December 31, 2025 in the CY2026 final rule) | The Accumulation | Primary read at the source | CMS ↗ | 2026-07-26 |
| CMS Innovation Center—Kidney Care Choices (KCC) Model record | The model record for the voluntary CKD/ESRD value-based model (2022; KCF option ended 12/31/2025; CKCC options extended through 12/31/2027) | The Accumulation | Primary read at the source | CMS ↗ | 2026-07-26 |
| CMS Innovation Center—Increasing Organ Transplant Access (IOTA) Model record | The model record for the transplant-access model (July 1, 2025 through June 30, 2031) | The Accumulation | Primary read at the source | CMS ↗ | 2026-07-26 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| CMS-2728 / CMS-2744 / CMS-2746 | The forms that open, count, and close the federal record of a person’s kidney failure | The Crossroads · The Border · The Stakeholder Matrix · The Data Map | Primary read at the source | CMS ↗ | 2026-07-15 |
| The ESRD Atlas dataset | The atlas’s own working model—45 entities, 78 relationships, built from the public sources on this page; the generated plates are drawn from it | The Crossroads · The Border · The Coverage Map · The Stakeholder Matrix · The Data Map | Primary text held in the workshop | esrd-atlas/data (the workshop) | 2026-07-26 |
| SOURCE | WHAT IT IS | CITED ON | HOW VERIFIED | LINK | CHECKED |
|---|---|---|---|---|---|
| League et al.—Variability in Prices Paid for Hemodialysis by Employer-Sponsored Insurance in the US, 2012-2019 (2022) | The claims study behind the commercial-multiple: mean $1,287 and median $1,476 per session paid by employer plans, against a Medicare base rate around $240 in the period | The Coverage Map | Primary read at the source | JAMA ↗ | 2026-07-14 |
| Medigap eligibility under age 65—state-by-state (medicareresources.org) | The state-by-state explainer of Medigap access for under-65 Medicare beneficiaries, including per-state ESRD treatment—a living page; state laws change | The Coverage Map | Via secondary summary—no primary artifact | medicareresources.org ↗ | 2026-07-14 |
| The ESA trial record—CHOIR, CREATE (2006) and TREAT (2009) | The three randomized trials that broke the higher-hemoglobin consensus: CHOIR and CREATE (NEJM, Nov 2006—harm and no benefit at higher targets) and TREAT (NEJM, 2009—darbepoetin, higher stroke risk) | The Benchmark Pipeline | Primary read at the source | nejm.org ↗ | 2026-07-14 |
| The unplanned-start and AKI-recovery literature (four peer-reviewed studies) | The studies behind the crash-start route and the AKI-recovery loop—unplanned starts are common (roughly a quarter to a third of entries), typically begin inpatient via catheter, carry worse first-year outcomes, and dialysis-requiring AKI recovers often enough that the loop back to CKD care is a real road | The Crossroads | Primary read at the source | pmc.ncbi.nlm.nih.gov ↗ | 2026-07-14 |
| Childers, Dworsky, Kominski & Maggard-Gibbons—A Comparison of Payments to a For-profit Dialysis Firm From Government and Commercial Insurers (2019) | The study behind the commercial-rate premium (about $1,041 vs $248 per session, about 4x Medicare) used to model the commercial inflow | The Money Flow | Primary read at the source | JAMA ↗ | 2026-07-14 |
| Applied Policy—CMS Finalizes 2.2 Percent Payment Increase (Nov 2025) | The secondary rule summary that reports $8.2B in CY2026 ESRD payments—disclosed on the Money Flow as the dissenting figure against CMS’s own $6B fact-sheet series | The Money Flow · The Coverage Map | Via secondary summary—no primary artifact | Applied Policy ↗ | 2026-07-14 |