R-HI can begin on the basis of a kidney transplant whether or not the patient has
been on renal dialysis prior to the transplant. Where there is no course of dialysis
that would result in earlier entitlement, R-HI begins with the month of transplant
(even if the patient dies during the transplant surgery) or, in “early entitlement
(transplant)” cases, as many as 2 months prior to the month of transplant, as explained
in HI 00801.221.A.2.
For entitlement purposes, the transplant does not have to take place in a hospital
approved by Medicare as a transplant hospital, e.g., the hospital may be located outside
the United States. However, Medicare payment is not made for services unless they
take place in a Medicare-approved facility.