CMS SOM App. H, Tag V513

The patient’s comprehensive assessment must

include, but is not limited to, the following: (10) Evaluation of suitability for a

transplantation referral, based on criteria developed by the prospective transplantation

center and its surgeon(s). If the patient is not suitable for transplantation referral, the basis

for non-referral must be documented in the patient’s medical record.

Interpretive Guidance §494.80(a)(10)

The IDT comprehensive assessment must demonstrate that each patient is evaluated for

suitability for transplantation referral, using selection/exclusion criteria provided by the

transplant program.

The regulations for transplant programs require the development and provision of written

selection criteria upon request to patients and dialysis facilities. Selection criteria vary among

transplant programs. If a dialysis facility refers patients to multiple transplant programs, the

facility should have the selection criteria for each program on file and available to patients.

Additionally, patients are free to select a transplant program other than the ones normally

utilized by the dialysis facility for referrals.

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If the assessment finds a patient is not suitable for transplantation, the reason for the non-referral should be documented as part of the comprehensive assessment.

The requirements for the plan of care for transplant status are at V554.