Registration fee collection
HRSA has developed a Pay.gov user guide for transplant centers as they transition to submitting payments through Pay.gov. View the OPTN Patient Registration Fees Pay.gov UserGuide (PDF - 3 MB).
On this page:
- What is the OPTN registration fee?
- OPTN registration fee collection: transition and timeline
- Improving transparency
What is the OPTN patient 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.
Beginning in October, the OPTN will publish information on the fees collected and how those funds are used.
New OPTN patient registration fee rate for FY26
On August 11, 2026, HRSA approved the OPTN Board of Directors’ recommended Fiscal Year (FY) 2027 OPTN Patient Registration Fee of $1,268 per transplant candidate, up from $1,036 in FY 2026. This fee will go into effect on October 1, 2026. Read a message from OPTN President John Magee and OPTN Treasurer Alan Reed.
HRSA’s decision is based on the following considerations:
- Operating costs: Before FY 2026, the OPTN registration fee had not changed for several years, even as inflation and other factors increased operating costs. Surplus funds in the OPTN operating account were used to cover the difference. Those funds have now been used, so the fee must increase to cover the ongoing cost of operating the OPTN.
- Planned and emerging needs: The fee also supports Board-approved policy projects and directives from the HHS Secretary. It includes funding for new or unexpected directives so the OPTN and HRSA can respond quickly to emerging patient safety and compliance needs.
November 2026 invoices (for candidates added between Oct. 1-31, 2026) and subsequent FY27 invoices will reflect the new fee of $1,268 per candidate.
OPTN patient registration fee collection transition
In February 2026, the new federal funding bill (HR 7148) was signed into law and extends HRSA’s authority to collect OPTN patient registration fees that was originally granted in the 2025 Full-Year Continuing Appropriations and Extensions Act (Sec. 1904 in P.L. 1968). For decades, UNOS, as the sole OPTN contractor, has managed this fee collection process.
Under the new law, HHS has assumed 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 only bills transplant centers for the OPTN Patient Registration Fee. The OPTN Patient Registration Fee is the only fee transplant centers are required to pay as OPTN members to support the operations of the OPTN under the OPTN Final Rule (42 CFR § 121.5). Any additional fees, such as the UNOS data fee, are payable at the discretion of the Transplant Hospital. Neither HRSA nor the OPTN has a role in billing or collecting those optional fees.
HRSA invoices for registration fees via Pay.gov, a secure, no-cost federal payment platform used by many U.S. government agencies. Currently, transplant centers have the option to pay their invoice via ACH debit or credit card in Pay.gov, or via ACH credit or wire transfer. HRSA will continue to keep transplant centers informed with timely email and webpage updates, detailed guidance, and clear timelines to support a smooth transition. Please see the HRSA Pay.gov User Guide (PDF - 3 MB) for more information for transplant centers. 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.
Fecha de la última revisión: