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What is the OPTN registration fee?

Most of the operating costs of the OPTN are paid for by patient registration fees. These fees are paid by transplant programs for each candidate they add to the national transplant waiting list. The fee amount is set each year by the OPTN Board and approved by HRSA. The current fee is $868 per patient added to the waitlist.

OPTN registration fee collection: transition and timeline

In March 2025, Congress passed the 2025 Full-Year Continuing Appropriations and Extensions Act (Sec. 1904 in P.L. 1968) which includes a key provision affecting the organ transplantation community. Section 1904 grants HHS explicit legal authority to directly collect and distribute registration fees from OPTN member institutions. For decades, UNOS, as the sole OPTN contractor, has managed this fee collection process.

Under the new law, HHS will now assume responsibility for collecting these fees, a shift designed to:

  • Enhance transparency in how fees are collected and used
  • Expand opportunities for multiple best-in-class contractors to support the operations of the OPTN
  • Strengthen oversight, performance, and accountability across the network

HRSA has initiated this transition by reaching out to transplant hospitals to confirm their billing points of contact and provide information on the transition to the new fee collection process. During this period, transplant hospitals should continue to pay the fees to the OPTN contractor until HRSA provides further instructions. HRSA anticipates beginning to invoice transplant hospitals in October 2025 for OPTN patient registration fees for transplant candidates added to the waiting list after August 31st, 2025.

HRSA anticipates collecting registration fees via Pay.gov, a secure, no-cost federal payment platform used by many U.S. government agencies. HRSA will keep transplant hospitals informed with timely email and webpage updates, detailed guidance, and clear timelines to support a smooth transition. If you are a transplant hospital with questions regarding registration fees, please contact OPTNFeeSupport@hrsa.gov.

Improving transparency

The new law also introduces new transparency measures, providing the transplant community and the public with greater visibility into how registration fees are allocated and spent. These measures ensure registration fees support OPTN operations and, ultimately, improve outcomes for patients and families.

HRSA will continue to update this webpage to share information on the new fee collection process, fees collected, and how fees were used to support OPTN operations.