How to accurately report Allo-HSC acquisition costs

Subsection (d) hospitals that furnish inpatient allogeneic hematopoietic stem cell (Allo-HSC) transplants must accurately report acquisition costs on their Medicare Cost Report.

These facilities must use Worksheet D-6 (Form CMS-2552-10), found in Chapter 40 of the Medicare Provider Reimbursement Manual, to report these costs. Hospitals may only include charges and costs associated with the recipients and expected recipients who receive these services at their own facility, regardless of whether the patients are Medicare beneficiaries or covered by a different payer. They must maintain an itemized statement of all applicable acquisition costs identified in 42 CFR § 412.113(e)(2).

Hospitals must keep records for all patients who receive Allo-HSC acquisition services, including both donors and recipients. The documentation must identify the prospective recipient associated with each donor source, as well as their identifier. For Medicare patients, the documentation must also include their Medicare Beneficiary Identifier.

When a hospital performs Allo-HSC acquisition services on behalf of another hospital, the National Marrow Donor Program, or similar entity, it must seek reimbursement from that organization. In this scenario, the performing hospital should not report the associated Allo-HSC charges on Worksheet D-6.

Medicare reimbursement for these services is based on the proportion of a hospital’s Allo-HSC transplants performed for Medicare beneficiaries. Find more information on billing Medicare for transplant services in Chapter 3 of the Medicare Claims Processing Manual.

Revenue integrity professionals at organizations that provide Allo-HSC transplants should review their cost reporting and documentation practices to ensure compliance with CMS requirements.