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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 412 - Prospective Payment Systems for Inpatient Hospital Services |
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Subpart G - Special Treatment of Certain Facilities Under the Prospective Payment System for Inpatient Operating Costs |
§ 412.100 - Special treatment: Kidney transplant programs.
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§ 412.100 Special treatment: Kidney transplant programs.
(a) Adjustments for kidney transplant programs.
(1) CMS adjusts the inpatient prospective payment system (IPPS) rates for inpatient operating costs determined under subparts D and E of this part for hospitals with approved kidney transplant programs (discussed at § 482.104 of this chapter) to remove the net costs associated with kidney acquisition.
(2)
(i) Payment for Medicare kidney acquisition costs, as set forth in subpart L of part 413 of this chapter, is made on a reasonable cost basis apart from the prospective payment rate for inpatient operating costs.
(ii) IPPS payment to the hospital is adjusted in each cost reporting period to reflect an amount necessary to compensate the hospital for reasonable costs of Medicare kidney acquisition.
(b) Costs of kidney acquisition. Kidney acquisition costs include allowable costs incurred in the acquisition of a kidney from a living or a cadaveric deceased donor , by the hospital, or from a deceased donor by an organ procurement organization, as appropriate. These costs are listed in § 413.402(b) of this chapter.
[ 86 FR 73511, Dec. 27, 2021, as amended at 87 FR 72286, Nov. 23, 2022]