Cost Report Appeals for OPOs

Published 06/23/2023

Palmetto GBA provides cost report appeal services for Jurisdiction J for Part A, Independent Organ Procurement Organizations (OPOs) and Histocompatibility Labs (Histo). The current Appeal Support Contractor (ASC) is Federal Specialized Services LLC (FSS).

Requests for hearing (i.e. appeals) for OPOs and Histo Labs are subject to an amount in controversy of $1,000 or more and fall under the jurisdiction of the Medicare Administrative Contractor (MAC) Hearing Officer which is FSS. Information and procedures for filing a MAC appeal are available at Part I of the Provider Reimbursement Manual, Chapter 29 (PRM-1).

All requests for hearing for OPOs and Histo Labs and correspondence/documentation should be submitted to FSS and Palmetto GBA in electronic format. Ensure that any Adobe attachments are legible. Providers should submit Excel spreadsheets where applicable. The subject line of the email should list the case number, provider name, provider number, fiscal year end and the nature of the correspondence: For example: "Subject: Case No., ABC Provider, Provider No. 12-3456, FYE XX/XX/XXXX, Final Paper."

If there are any questions related to these appeal filing instructions, please contact Cecile Huggins at

The contacts and mailing addresses for filing and submitting cost report appeal information are included below.

MAC Appeals for OPOs and Histo Labs

Amount in controversy: 

$1,000 or more

Send request to the ASC:

Federal Specialized Services (ASC)


Intermediary Hearing Officer



If filing documents electronically is not an option for the provider, use the address below to file unboud correspondence:

U.S. Mail or Courier Service

Federal Specialized Services

Intermediary Appeals

1701 S. Racine Avenue

Chicago, IL 60608-4058


U.S. Mail
Palmetto GBA
Provider Cost Report Appeals 
Attn: Cecile Huggins
Internal Mail Code: AG-380 
Post Office Box 100307
Columbia, SC 29202-3307 

Courier Service 
Palmetto GBA
Provider Cost Report Appeals 
Attn: Cecile Huggins 
Internal Mail Code: AG-380 
2300 Springdale Drive, Bldg. One 
Camden, SC 29020-1728

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