US · guidance
CMS Pub. 100-02, ch. 11, § 140.7
Kidney Recipient Evaluated for Transplant During Inpatient
Stay
(Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26)
A3-3178.7, RDF-233.3
When a potential kidney recipient is admitted to a hospital for a medical reason other than
in anticipation of a transplant, but during the stay, a medical evaluation for an anticipated
kidney transplant is performed, all hospital and physicians’ services costs applicable to
the medical evaluation are considered kidney acquisition costs. Accordingly, those
services will be treated the same as the services described in section 140.6. However, all
hospital and physicians’ services applicable to the nontransplant related services (i.e.,
related to the medical services for which the patient was actually admitted) must not be
included with kidney acquisition costs; instead the costs of such services must be billed in
the same manner as any other inpatient service on the account of the recipient. These
latter services may be billed to the Medicare program only if the recipient has actual
Medicare entitlement.
History
(Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
22c3bf832612ec2ce86c3277d2b104526d778a0362a4bb88a9a571042fbea508
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