Alliance of Wound Care Stakeholders Drives Policy Progress in 2024
In a recent blog post on the HMP Global Learning Network, Marcia I. Nusgart, RPh, Executive Director of the Alliance of Wound Care Stakeholders, highlighted the organization’s major regulatory and policy accomplishments throughout 2024. These initiatives have advanced equitable reimbursement, clarified billing practices, and protected patient access to vital wound care treatments.
Key Highlights:
- National Payment Rate for Autologous Blood-Derived Products: The Alliance successfully advocated for CMS to establish a standardized national payment rate under HCPCS code G0465 for platelet-rich plasma (PRP) and similar autologous blood-derived therapies used in chronic wound care. This helps eliminate inconsistent payment practices among Medicare Administrative Contractors (MACs).
- Billing Clarity for Skin Substitutes: The Alliance worked with CMS to clarify that application of skin substitutes in physician office settings can be billed using standard CPT codes, even when the products are provided at no cost. This clarification ensures continued patient access to these critical therapies.
- Revisions to Draft LCDs: The Alliance played a leading role in revising several Local Coverage Determinations (LCDs) involving skin substitutes. Their comments ensured coverage policies remained evidence-based and clinically sound, protecting patient access and aligning guidelines with real-world practice.
Through its active engagement with CMS and MACs, the Alliance of Wound Care Stakeholders continues to shape policy that supports quality care and fair reimbursement. Its ongoing advocacy helps wound care professionals deliver timely, effective treatments while minimizing administrative and financial obstacles.
Read the full article on the HMP Global Learning Network website.
Keywords:
wound care policy,
CMS reimbursement,
skin substitutes,
Marcia Nusgart