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Site Neutrality – a Looming Disaster or an Opportunity?

Site Neutrality – a Looming Disaster or an Opportunity?

by Caroline Fife, M.D. | Jun 5, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy

There’s a new article in Health Affairs about “site neutral” payments that could change everything for hospital-based outpatient departments – and by that, I mean, possibly end them. However, I have been wrong about this threat for more than a decade – which means...
Thank You to the WOCN for Asking Me to Provide an Update on the “Skin Substitute” Market!

Thank You to the WOCN for Asking Me to Provide an Update on the “Skin Substitute” Market!

by Caroline Fife, M.D. | Jun 2, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

I had a great time speaking at the WOCN conference in Orlando! I was asked to provide an update on “Skin Substitutes.” I will give you a few highlights from the talk. I reviewed the reasons we need skin substitutes, such as the huge percentage of patients suffering...
Letter about Cellular Tissue Products / Skin Substitutes Used on Pressure Ulcers

Letter about Cellular Tissue Products / Skin Substitutes Used on Pressure Ulcers

by Caroline Fife, M.D. | Apr 28, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, The Patient's Voice

I just got this letter by email from a physician emphasizing (in addition to the ethical issues) the need for clinical studies of Cellular Tissue Products / Skin Substitutes on pressure ulcers. Thoughts anyone? –Caroline Dear Dr. Fife, I am writing to express a...
CMS Needs to Fix the Root Cause – the CTP/CAMP Payment Structure

CMS Needs to Fix the Root Cause – the CTP/CAMP Payment Structure

by Caroline Fife, M.D. | Apr 23, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

Hi Dr. Fife, Here’s my two cents as someone who has lived this mess for a long time now. The root cause of this issue is the CMS payment structure. CMS has known about this problem this for years.  Every year they talked about fixing it and every year they chose...
Human Amniotic Products are 76.3% of the Almost $2 Billion US “Skin Substitute” Market

Human Amniotic Products are 76.3% of the Almost $2 Billion US “Skin Substitute” Market

by Caroline Fife, M.D. | Apr 16, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

SmartTRAK is reporting that in the 4th quarter of 2024 (Q424) the “skin substitute” market reached almost $2 billion, an increase of 25% compared to the 4th quarter of 2023 (Q423). Human amniotic products represent the majority of the US market at 76.3%, up from 72.1%...
Shoot the Messenger But Please Read the Message First

Shoot the Messenger But Please Read the Message First

by Caroline Fife, M.D. | Apr 14, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

I didn’t write the New York Times article about “skin substitutes” It was written by Sarah Kliff and Katie Thomas. You can send them your comments at nytimes.com/tips. Jeanne Pinder at Clear Health Costs also has a new article: “Wound Care Regulations Delayed...
Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut – The New York Times

Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut – The New York Times

by Caroline Fife, M.D. | Apr 11, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

Check out the article in the New York Times about “skin substitutes.” Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut – The New York Times “Medicare spending on ‘skin substitutes’ made of dried placenta has soared as doctors pocket...
LCDs Appear to be Delayed & Cellular Tissue Product / Skin Substitute Prices Continue to Soar

LCDs Appear to be Delayed & Cellular Tissue Product / Skin Substitute Prices Continue to Soar

by Caroline Fife, M.D. | Apr 11, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

LCDs appear to be delayed until 1/1/26 based on MAC websites changing the revision effective date. More news as I get it. There’s now an amniotic that is over $5,000 per cm2. I wonder how high the prices will go by next January? CMS Statement on Local Coverage...
Check Out an Opinion Piece in RealClear Health About the “Skin Substitute” LCD

Check Out an Opinion Piece in RealClear Health About the “Skin Substitute” LCD

by Caroline Fife, M.D. | Apr 9, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

An opinion piece has been published in RealClear Health about the upcoming launch of the “skin substitute” LCD(s), authored by the president of Consumer Action for a Strong Economy (CASE). (RealClear Health is part of RealClear Politics). The article...
The Daunting Documentation Demands of the LCD: Why Templates & Lists Will Not Suffice

The Daunting Documentation Demands of the LCD: Why Templates & Lists Will Not Suffice

by Caroline Fife, M.D. | Apr 8, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes

Here’s another guest blog from Michael Crouch who is a professional coder and medical auditor, detailing the documentation demands of the LCDs. It’s true that we don’t know if the LCDs will be implemented on April 13th. However, with or without the implementation...
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Wound Care Reimbursements

Recent Articles

  • Cellular Tissue Product / Skin Substitute Payment Proposed Rule – the Illustrated Version July 25, 2025
  • Arizona NP Pleads Guilty to Medicare Fraud Over “Skin Substitutes” July 23, 2025
  • Hyperbaric Physicians (and Hospital Program Managers): Check the 2023 Medicare Data! Protect Your NPI and Don’t Put Hospital Facility Fees at Risk July 21, 2025
  • Just Released: Hospital Outpatient Proposed Rule Would “Unbundle” Cellular Tissue Products (CTP) / Skin Substitutes in the HOPD July 17, 2025
  • BREAKING NEWS! 2026 MPFS Proposed Rule Sets Single Payment Amount for all “Skin Substitutes” at $125.38/cm2 July 15, 2025

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