Living Kidney Donor Evaluation, Patient Has Entitlement or is

140.5 - Living Kidney Donor Evaluation, Patient Has Entitlement or is in Pre-entitlement Period (Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26) A3-3178.5, RDF-233.1 When a living donor is admitted to a hospital (before admission for excising the donor kidney) for a medical evaluation in anticipation of a kidney donation, all hospital and physicians’ services costs applicable to medical evaluation are considered kidney acquisition service costs. As such, the hospital statistics (charges, patient days, etc.) and the physicians’ charges should be treated in accordance with all other kidney acquisition service statistics, and the related costs are included in the Medicare hospital cost report for kidney acquisition. When the living donor subsequently enters the hospital for the actual excision, the hospital costs of services rendered to the donor will continue to be treated as kidney acquisition costs under Part A. However, at that point physician services are no longer considered kidney acquisition costs and are not reimbursable under Part A. Instead, during the living donor’s inpatient stay for the excision surgery and during any subsequent living donor inpatient stays resulting from a direct complication of the kidney donation, physician services are billed under Part B. They are billed in the normal manner but on the account of the Medicare transplant recipient at 100 percent of the fee schedule. Note that services furnished to living kidney donors are covered under the Medicare Beneficiary Identifier of the Medicare transplant recipient. Services listed in the following sections are also covered. However, they are not billed as such but become a part of the kidney acquisition costs and are included in the kidney acquisition cost center on the Medicare hospital cost report.