| Evaluation criteria | Rating |
|---|
| Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient | 100% |
| Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 80% |
| Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 60% |
| Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 30% |
| GFR from 60 to 89 mL/min/1.73 m2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or |
| GFR from 60 to 89 mL/min/1.73 m2 and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or |
| GFR from 60 to 89 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months | 0% |
| Note: GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional. |
| Evaluation criteria | Rating |
|---|
| Urinary retention requiring intermittent or continuous catheterization | 30% |
| Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following: |
| 1. Post void residuals greater than 150 cc. |
| 2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec). |
| 3. Recurrent urinary tract infections secondary to obstruction. |
| 4. Stricture disease requiring periodic dilatation every 2 to 3 months | 10% |
| Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year | 0% |
Source: eCFR Title 38, §4.115a, 4.115b, current as of 2026-11-05. Criteria are reproduced verbatim for reference.