With the exception of cornea transplants, all Medicaid-covered transplants must be prior authorized. Medicaid benefits cover prior authorized heart, lung (both single and double), heart/lung, liver, pancreas, pancreas/small bowel, kidney and bone marrow transplants. Other medically necessary transplants are covered for children under age 21 when the need is identified during an EPSDT screening and is prior authorized by Medicaid.
Transplant services are limited to in-state providers unless there are no in-state providers to perform the procedure. All prior authorized transplants must be coordinated through the University of Alabama Birmingham's transplant staff.
For more information about transplants services, contact Russell Green at Russell.green@medicaid.alabama.gov or Marshetia Baldwin at Marshetia.baldwin@medicaid.alabama.gov.