KED Calculator – Kidney Contenders®

Logic aligned with KED (Kidney Health Evaluation for Patients with Diabetes) process measure: compliant when both eGFR and uACR are completed in the measurement year.

Quality Measures + Claims Logic

Age Range: 26–35

Descriptor: rising metabolic-risk group

National KED Performance Rate: 49%

Testing Rates (eGFR + uACR): 20–40%

DKD Prevalence: higher obesity/metabolic risk

State-Level KED Participation:
CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA, WI

CPT/HCPCS Codes for KED

Description: Creatinine; blood

National Payment Rate: $5.12

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)

Description: Creatinine; clearance

National Payment Rate: $9.46

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)

Description: Basic metabolic panel including Ca, CO₂, Cl, Creatinine, Glucose, K, Na, BUN

National Payment Rate: $8.46

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)

Description: CMP including Albumin, Bilirubin, Ca, CO₂, Cl, Creatinine, Glucose, Alk Phos, K, Protein, Na, ALT, AST, BUN

National Payment Rate: $10.56

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)

Description: Albumin; urine (microalbumin), quantitative

National Payment Rate: $5.78

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)

Description: Creatinine; other source

National Payment Rate: $5.18

Additional Info: CLIA‑Waived Test

PA Requirement: No prior authorization required (routine lab test)