CMS proposes updates to coverage policy for Autologous Blood-Derived Products for chronic non-healing wounds

Dec. 28, 2020

The Centers for Medicare & Medicaid Services (CMS) announced that is proposes to update the coverage policy for Autologous Blood-Derived Products for Chronic Non-Healing Wounds.

Specifically, the CMS is proposing to update coverage of platelet rich plasma (PRP) for the treatment of chronic non-healing diabetic, venous, and pressure wounds. PRP is a blood-derived product prepared from the patient’s own blood to be used as a wound covering in the management of chronic wounds.  PRP is currently covered under the Coverage with Evidence Development (CED) pathway for the treatment of chronic, non-healing diabetic, venous, and pressure wounds when beneficiaries are enrolled in a clinical study. The proposed NCD issued would eliminate the CED requirement and nationally covers platelet rich plasma for the treatment of chronic non-healing diabetic wounds. The proposal also would provide for coverage determinations for PRP for all other chronic non-healing wounds to be made by local Medicare Administrative Contractors.

“Today’s proposed decision for platlete rich plasma demonstrates CMS’ ironclad commitment to update our coverage policies so they reflect the most current medical evidence,” said CMS Administrator Seema Verma. “America’s seniors deserve constant vigilance on the part of Medicare to ensure the best treatment options are available. Under President Trump’s leadership CMS has given them exactly that.”

CMS is seeking comments on the proposed national coverage determination. All public comments may be submitted at https://www.cms.gov/medicare-coverage-database/indexes/nca-open-for-public-comment-index.aspx. A final decision will be issued no later than 60 days after the conclusion of the 30-day public comment period.

CMS has the release.

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