Key PointsQuestionIs dialysis facility–level commercial payer mix associated with patient access to kidney transplant?FindingsIn this cohort study including 233 003 patients receiving incident dialysis, commercial insurance at the patient-level was associated with increased wait-listing for kidney transplant within 1 year, but there was no significant independent association of facility-level commercial payer mix with wait-listing.MeaningThese findings suggest that while patient insurance status was associated with access to kidney transplant, dialysis facility payer mix did not itself have an association with wait-listing; nevertheless, as the landscape of insurance coverage for dialysis evolves, the potential downstream impact on access to kidney transplant should be monitored.