News Releases

February/March webinar series highlights key 2025 changes to payment and coverage policies that impact wound care, providing actionable insights to help health professionals navigate complex policies and ensure they are prepared for changes that affect clinical practice.

(February 4, 2025) — An educational partnership between HMP Global and the Alliance of Wound Care Stakeholders will give health care professionals the critical information they need to understand the impact of 2025 Medicare policy updates on wound care. The new webinar series will address key changes to payment and coverage policies and their impacts, ensuring that wound care providers are equipped with the knowledge needed to implement these changes effectively in their practices. The seminar series in February and March will specifically focus on new provisions within the 2025 Medicare Physician Fee Schedule (MPFS), the Hospital Outpatient Prospective Payment System (OPPS), and the Home Health Prospective Payment System (HH PPS), plus the Local Coverage Determinations (LCDs) on Cellular and Tissue-Based Products (CTPs/skin substitutes) for Diabetic Foot Ulcers and Venous Leg Ulcers and their accompanying Billing and Coding Articles.

Each of the three webinars will summarize the “need to know” 2025 policy updates, then delve into how changes will impact clinicians across different care settings, including private practices, provider-based departments, and home health services. Experts will share real-world implementation experiences, challenges and tips. 

• Ready! Set! Go! Implement 2025 Medicare Final Rules: MPFS, OPPS, and Home Health PPS 
  Wednesday, February 12 at 1 p.m. ET
  Speakers: Karen S. Ravitz, JD, Health Policy Advisor, Alliance of Wound Care Stakeholders; Kathleen D. Schaum, MS, President, Kathleen D. Schaum & Associates
  REGISTER TODAY
   
• Tips for Implementing the CTP LCD in Your Practice
  Wednesday, February 26 at 2 p.m. ET
  Speakers: Kathleen D. Schaum, MS; Kara Couch, MS, CRNP, Director of Wound Care Services, George Washington University Hospital; Gayle M. Gordillo, MD, FACS, Senior Medical Director of Wound Services, University of Pittsburgh Medical Center; Marcia Nusgart, R.Ph., CEO and Founder of the Alliance of Wound Care Stakeholders; Karen S. Ravitz, JD
  (Registration Opens Soon)
   

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1/25/25 - All of the Medicare Administrative Contractors (MACs) have delayed the effective date of the final local coverage determinations for cellular and tissue-based products for wounds (CTPs, or "skin substitutes") in diabetic foot ulcers and venous leg ulcers by 60 days, moving the implementation date across all MAC jurisdictions from 2/12/25 to 4/13/25.

Note: the local coverage determinations themselves are unchanged, only the effective date has postponed.

As there were seismic changes to the number of covered products, allowable applications, and required documentation in the final LCDs published in November 2024, wound care providers across the country who treat DFU/VLU in Medicare beneficiaries have been preparing for the original February 12, 2025 implementation date. This 60 day postponement to April 13th has the upside of providing additional preparation time.  

See the "Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers & Venous Leg Ulcers" LCDs from each MAC below.

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Statement from the Alliance of Wound Care Stakeholders

November 19, 2024 – The Alliance of Wound Care Stakeholders is pleased that CMS’ Medicare Administrative Contractors (MACs) carefully considered stakeholder recommendations and made substantive changes following input from the wound care community in the recently released final Local Coverage Determinations (LCDs) and accompanying Coding and Billing Articles, “Skin Substitute Grafts/Cellular and Tissue-Based Products (CTPs) for the Treatment of Diabetic Foot Ulcers & Venous Leg Ulcers.” With publication of the final policy by each MAC, the wound care community now has clearer understanding of Medicare coverage for the application of CTP/skin substitute products in treating diabetic foot ulcers (DFU) and venous leg ulcers (VLU). The Alliance and the larger wound care clinical community mobilized together, illustrating the power of tenacious advocacy and a unified voice to positively influence policies so that they reflect quality wound care practice. In a noted change that was in direct alignment with Alliance recommendations, the MACs increased the covered application limit from 4 to 8 in the final policy, now consistent with the supportive clinical evidence, treatment guidelines and current standard of care to promote wound healing. Similarly,

• CTPs/(skin substitutes)
• LCDs

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The Alliance of Wound Care Stakeholders is pleased to announce the appointment of four new members to its Board of Directors. The expansion of the Board will strengthen and diversify the expertise of Alliance leadership and governance structure and enable us to make an even more significant impact by bringing in new perspectives and expertise to serve the wound care community and achieve our strategic objectives. Join us in welcoming Dr. David Alper, Michelle Cooper, Deanna Primozic, and Julie Rhodovi. Read more about these impressive individuals in the press release below. 

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Following tenacious collaborative advocacy from the Alliance of Wound Care Stakeholders and across the wound care community, three Medicare Administrative Contractors – Novitas, First Coast Service Options, and CGS Administrators – today withdrew their local coverage determinations (LCDs) and local coverage articles (LCAs) that that would have dramatically restricted Medicare patients’ access to cellular and tissue-based products for wounds (CTPs, or "skin substitutes”), advanced wound care treatments that are instrumental to wound healing. The policies were scheduled to go into effect on Oct. 1st but have now been pulled. “This was a collaborative effort across the wound care community and, with the withdrawal of the policies, our advocacy clearly had impact. The real winners here are Medicare beneficiaries with chronic wounds who now won’t face disruptions to care or unnecessary restrictions to treatments that can support wound healing,” said Marcia Nusgart, R.Ph., CEO of the Alliance. 

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• CTPs/(skin substitutes)
• LCDs
• Novitas FCSO CGS LCD

The Alliance commemorated its 20th anniversary with a video highlighting its work and impact driving change and moving wound care forward over the past twenty years. 

Sept. 19, 2022 – The Alliance of Wound Care Stakeholders urged the Centers for Medicare and Medicaid Services to update inadequate payment methodologies for cellular and/or tissue-based products for skin wounds (CTPs, or “skin substitutes”) to ensure appropriate access to care in the hospital outpatient/provider-based department (PBD) site of service. In comments submitted to CMS’s proposed 2023 Hospital Outpatient Prospective Payment System updates, the Alliance forwarded specific recommendations to correct policy and payment challenges that are negatively impacting access to CTPs in provider-based departments. These include...
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• CMS
• CTPs/(skin substitutes)
• HOPPS

Sept. 13, 2022 - The Alliance of Wound Care Stakeholders, the leading voice for wound care advocacy and education to address public policy issues impacting patient access to care, marks two decades of experience in addressing many issues of commonality for its members that include clinical and patient associations, wound care clinics and business entities spanning manufacturers and distributors, providers, researchers and reimbursement experts. The Alliance takes pride in its role as a key collaborator and resource for numerous government agencies, providing insights and guidance on issues impacting coding, coverage and payment, as well as quality measures and wound care research. “As we look back on our 20 years of serving multiple stakeholders across the wound care community, we are gratified to reflect on significant advocacy and educational outreach activities in the regulatory, legislative and public arenas,” says Marcia Nusgart, R.Ph., CEO, The Alliance. 
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Sept. 7, 2022 - The Alliance alerted the Centers for Medicare and Medicaid Services (CMS) that changes to the way cellular and/or tissue-based products for skin wounds (CTPs, or “skin substitutes”) are coded and paid for in the physician office under the proposed 2023 Physician Fee Schedule will create barriers to care that could ultimately lead to increased amputations and infections for patients with chronic non-healing wounds. The Alliance urged CMS to delay implementation of the proposed provisions until patient access issues can be further studied. “Under the proposed 2023 policy, payments for CTPs and their application will simply not cover the costs to physician offices. Without adequate reimbursement, many physicians will no longer be able to afford to provide these medically necessary and successful advanced treatments to their patients. This would deprive patients these valuable treatment options which, in turn, could ultimately result in an increase in infections as well as amputations," the Alliance told CMS in submitted comments.
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• CMS
• CTPs/(skin substitutes)
• Physician Fee Schedules

September 2021 – The Alliance of Wound Care Stakeholders voiced opposition to payment cuts that would negatively impact wound care providers and their patients in recent comments to the Center for Medicare and Medicaid Services’ (CMS) proposed CY2022 Physician Fee Schedule and proposed Hospital Outpatient Prospective Payment System (HOPPS) regulations. The Alliance challenged cuts to surgical procedures, physical therapy services, disposable negative pressure wound therapy and compression payment as well as provided recommendations to remove barriers to CTPs. The final regulations from CMS are expected to issue in November.
See Alliance News Release

• CMS
• CTPs/(skin substitutes)
• Negative Pressure Wound Therapy (NPWT)
• Physician Fee Schedules
• Pneumatic Compression
• HOPPS