CMS Withdraws Proposal to Limit Coverage of Post-Transplant Monitoring

The Centers for Medicare and Medicaid Services (CMS) announced that it will rescind a proposed draft coverage policy that would have restricted coverage of surveillance monitoring for organ transplant recipients.

CMS will reinstate Medicare coverage of noninvasive post-transplant blood tests routinely used to monitor organ health, regardless of whether a surgical biopsy might otherwise be ordered. CMS also noted that a new Local Coverage Determination is forthcoming.

Noninvasive blood tests, such as donor-derived cell-free DNA and gene expression profiling, are critical tools for earlier detection of organ transplant injury and rejection. They also provide a less invasive alternative to traditional biopsy.

The decision to maintain coverage for these essential diagnostic tools follows a 15-month campaign by patients, clinicians, transplant organizations, and legislators advocating for their importance.