With the Managed Transplant Program, you can better manage risk, control costs and improve patient outcomes.

Transplant costs can be extremely unpredictable, and your medical stop loss insurance or reinsurance coverage may not provide complete protection. Optum manages the clinical and financial aspects of transplant cases through our fully insured transplant carve-out product, Managed Transplant Program (MTP).

MTP combines access to the Optum nationwide Centers of Excellence transplant network with specialized clinical expertise and years of claims adjudication knowledge. This offers unmatched cost management and risk protection against high-cost transplant medical expenses.

• High-cost care: Average billed charges range from $446,000 to $4 million depending on transplant type.^*
• Significant health plan exposure: For a 100,000-life group, there is $[OM1] 17 million transplant exposure.^*
• Transplant utilization on the rise: 1 in 5,252 members will experience a transplant.^*
• Experience and scale: We have 35+ years of experience managing transplants.

Network Maps

Transplant Centers of Excellence Network
Pediatric Transplant Centers of Excellence Network

Transplant Review Guidelines

Stem Cell Transplant Review Guidelines

Solid Organ Transplant Review Guidelines

NCQA Accreditation for Utilization Management and Credentialing

May 30, 2023 – May 30, 2026

OptumHealth Care Solutions, LLC.

*Ortner N, Holzer H. 2025 U.S. organ and tissue transplants: Estimated costs and utilization, emerging issues, and solutions. Feb. 13, 2025.