What should a Certified Transplant Center (CTC) be billing an Organ Procurement Organization (OPO) for when the CTC provides an organ to an OPO?
Due to a recently discovered discrepancy between the Provider Reimbursement Manual 15-1, Section 2771 and the Medicare Intermediary Manual 13-2, Section 3612, CMS is instructing intermediaries to allow either the standard acquisition charge (SAC) which reflects the average cost associated with acquiring each type of organ or their departmental charges by a CTC to an OPO for organ retrieval services. CTCs must still bill the SAC third party payers, including Medicare, for organs acquired and transplanted. Departmental charges cannot be billed for this purpose.
