Billing and Reimbursement for Advanced Practice in Solid Organ Transplantation

Abstract

Transplantation is considered the treatment of choice for end-stage organ failure in most organ systems. Kidney transplantation is cost-saving as compared with dialysis, and the cost utility of liver transplantation is favorable compared with other accepted medical interventions; nonetheless, transplantation is an expensive endeavor. As a result, both hospitals and payers have made considerable efforts to try to limit the costs associated with transplantation; these efforts have resulted in complicated reimbursement schemes and a variety of models to deliver care. It is in this context that many institutions have looked to incorporate advanced practice professionals in the care of transplant patients. The ability to use advanced practice professionals in a cost-effective manner can be enhanced by an understanding of how reimbursement in transplantation works and the legal and financial implications of their employment.