US · guidance
CMS Pub. 100-04, ch. 4, § 231.10
Billing for Autologous Stem Cell Transplants
The hospital bills and shows all charges for autologous stem cell harvesting,
processing, and transplant procedures based on the status of the patient (i.e., inpatient
or outpatient) when the services are furnished. It shows charges for the actual
transplant, described by the appropriate ICD procedure or CPT codes in Revenue
Center 0362 (Operating Room Services; Organ Transplant, Other than Kidney) or
another appropriate cost center.
The CPT codes describing autologous stem cell harvesting procedures may be billed and
are separately payable under the Outpatient Prospective Payment System (OPPS) when
provided in the hospital outpatient setting of care. Autologous harvesting procedures are
distinct from the acquisition services described in Pub. 100-04, Chapter 3, §90.3.1 and
§231.11 of this chapter for allogeneic stem cell transplants, which include services
provided when stem cells are obtained from a donor and not from the patient undergoing
the stem cell transplant.
The CPT codes describing autologous stem cell processing procedures also may be billed
and are separately payable under the OPPS when provided to hospital outpatients.
History
(Rev. 3556, Issued: 07-01-2016; Effective: 01-27-16; Implementation: 10-03-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7c6e43f009593579622592a1b4a5ca00c590320b8aba8a8159d9787a0b23c343
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