Cellular / Tissue-Based Products (CTPs)

I may post more information about the meeting later, but the general tone of the MAC medical directors was confident.

The lengthy report includes one account related to CTPs/skin subs which I mentioned in a previous blog when it happened.

This email inquiry is from a real patient who is a retired nurse.  I can answer some of her questions but not all of them, particularly the ones around when a patient might be required to sign...

Investigations regarding various aspects of “skin substitute” use are on the list along with the expected release dates for the reports.

I wonder what their marketing will look like 12 weeks from now?

The policies will become effective for services on or after 02/12/2025.

LCD – Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (L39756)

The sad news is that CMS is going ahead with a 2.9% cut to Medicare physician reimbursements for 2025.

SAHS billing activity for CTPs threatens the MSSP, and skin subs are part of the reason.

I started to explain the ethical problems associated with all of this, but I should not have to explain it.

How do I feel about using the money that falls out of the Brinks van to fund unmet healthcare services? Truthfully, I feel uncomfortable.

We should stop the public outcry about how “vulnerable patients” with “the most serious limb threatening” wounds will lose access to these products.

The settlement resolves allegations of false claims in connection with Mohs surgeries.

“…CTPs can be offered only to patients with secondary insurance or to those patients who are wealthy enough to afford the copay.”

Thank you for participating in the poll to guess how ridiculously high amniotic prices will go. Check out the final results!

The billing of CTPs in the doctor’s office is unchanged. The 2025 Medicare conversion factor is set to decrease for the fifth straight year.

At first glance, there are no changes to Cellular Tissue Product /skin substitute payment, which remain under package pricing in this site of care.

Can anyone explain how this dual invoice system for amniotic products could be used to line the pocket of a practitioner?

Sadly, it appears that the CTP/skin sub industry has become a game, the goal of which is to fleece Medicare.

There are amniotic products out there now which are more than $3,000 cm2, and there is ZERO data to suggest that they are any better than amniotic products 100 times cheaper.

I have been provoked into anger — for good reasons. It’s not my fault! I can’t help how I feel! Right?…

I got this letter today about Cellular Tissue Products being administered at patients’ homes. I’d like to know what people think…

Yesterday morning, 8 MACs issued nearly identical draft coverage policies for the use of CTPs (“skin subs”) in diabetic foot ulcers and venous leg ulcers.

Where will this end?

A friend sent me this email from a Cellular Tissue Product (CTP) / skin substitute rep. I ran out of words a long time ago. Message me if you have any words.

We’ve spent a lot of time talking about what is broken, now is the time to collaborate in a positive way about how to make it better.

The Medicare trust fund is bankrupt and this “profit” is funded by our tax dollars. How does that make you feel?

I am told that this case is cited in training programs for pharmaceutical sales reps to highlight the fact that “Selling the Spread” is a violation of Federal law etc.

You should read the whole report (it’s not very long), but I am going to provide some excerpts.

. If CMS or the MACs try to “fix” the situation without input from us, we have seen how unfortunate the results can be.

We could figure this out if we wanted to, but right now there’s so much money to be made that it’s an uphill battle.

Do you think that the [current CTP payment system] supports thoughtful patient care and the medically appropriate use of CTPs in the physician’s office?

With these answers, perhaps we can begin talk about what kind of policies would FIX this mess, pretending we could get anyone to listen.