Adult Liver Transplantation

Medicare covers adult liver transplantation for end-stage liver disease when performed in a CMS‑approved facility, and covers transplantation for hepatocellular carcinoma only if the patient is ineligible for subtotal resection, tumor(s) are ≤5 cm, there is no macrovascular involvement or extrahepatic spread, and the transplant is in a CMS‑approved facility. MACs may locally determine coverage for extrahepatic unresectable cholangiocarcinoma, neuroendocrine tumor liver metastases, and hemangioendothelioma; other malignancies remain excluded. Follow-up care and necessary re-transplantation related to covered transplants are covered, and immunosuppressive drug coverage follows referenced Medicare manual provisions.

"Medicare covers adult liver transplantation for end-stage liver disease (ESLD) in adults when performed in a facility approved by CMS as meeting institutional coverage criteria."