The CMS newsroom just released this press release yesterday, announcing that Final Local Coverage Determinations (LCDs) for Certain Skin Substitutes Have Been Withdrawn.
Effective immediately, CMS’ A/B Medicare Administrative Contractors (MACs) are withdrawing the Local Coverage Determinations (LCDs) for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers that were scheduled to become effective on January 1, 2026.
For more information on the LCD process, see Local Coverage Determination Process & Timeline.
–Caroline Fife
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
So what does this mean? That the crazy stuff is going to continue?
Lobbying is a hell of a drug
Will the payment scheme of $127 push through?
So are we back to 2025? All the Q codes that were sufficiently efficacious for the HCPCS Coding Committee
are now back in place in the LCD? What about the ASP process? Does this in any way postpone WISeR as well?
The reimbursement will reduce to $127 and change per cm2. MAC is going to be able to decide which skin subs they will pay for. They will probably pay for the commonly used ones. It’s all about the money and they may use the previous LCD’s.