by Caroline Fife, M.D. | Dec 29, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
It was downright hot in Texas for Christmas (~80° F) but for New Year’s Eve, the storms battering the northeast are making their presence known as far south as Houston and the temperature has dropped 40 degrees in a few hours. The “skin substitute” market has been as...
by Caroline Fife, M.D. | Dec 25, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
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release yesterday, announcing that Final Local Coverage Determinations (LCDs) for Certain Skin Substitutes Have Been Withdrawn.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...
by Caroline Fife, M.D. | Dec 23, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The Medicare final rule on the payment policy for CTPs/skin substitutes discussed the possibility of creating different pricing structures based on the product’s FDA pathway – particularly for “BLA” products. I didn’t know there were any BLA products approved for...
by Caroline Fife, M.D. | Dec 16, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
CMS just released this fact sheet: Upcoming Update to the Final Local Coverage Determinations (LCDs) for Certain Skin Substitutes | CMS Upcoming Update to the Final Local Coverage Determinations (LCDs) for Skin Substitute Grafts/Cellular and Tissue-Based Products...
by Caroline Fife, M.D. | Dec 10, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
This is a belated Thanksgiving message, but it has taken awhile for me to think through the sweeping changes that happened to CTP/CAMP/skin substitute payments on the last day of October. Here’s a list of what I think are the positive impacts and I hope you will send...
by Caroline Fife, M.D. | Nov 20, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
This is the third installment of a post by Michael Crouch recounting in exhaustive detail one clinician’s journey through a 15-month audit on her use of “skin substitutes” (CTPs/CAMPs). Mr. Crouch’s 3-part article can serve as a blueprint for the hundreds of other...
by Caroline Fife, M.D. | Nov 17, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Dr. Fife – When we last left our clinician, whose CTP/skin substitute claims were being audited by a Unified Program Integrity Contractor (UPIC) and their Medicare Administrative Contractor (MAC), she had been told that allografts when applied to wounds were not...
by Caroline Fife, M.D. | Nov 5, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Do the Right Thing: Thoughts on Quality
Months ago, Medicare announced its intention to change the payment model for CTP/CAMPs and create a fixed payment rate of around $125/cm2. Many thought that the proposed payment rate would be increased substantially in response to Congressional lobbying. These efforts...
by Caroline Fife, M.D. | Nov 3, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Hi Caroline, I just read the great article by Mike Crouch on the UPIC audits around skin substitutes. We’re looking at a UPIC denial for a patient we successfully grafted last year. They claim we had no weekly measurements! Absurd!! They said we don’t measure wounds...
by Caroline Fife, M.D. | Nov 1, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Breaking news! Physician fee schedule finalized-CTPs/CAMPS priced at ~ $127.28/cm2. Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) More information to come – stay tuned! Caroline Fife Caroline Fife, M.D.Dr. Fife is a world...
