Blood-Derived Products for Chronic Non-Healing Wounds

CMS National Coverage Determination | ncd_id=217 | manual_section=270.3 | coverage_level_code=3 | national_coverage_type=True | under_review=True | lab_ncd=False

B. Nationally Covered Indications Effective for services performed on or after April 13, 2021, the Centers for Medicare & Medicaid Services (CMS) will cover autologous PRP for the treatment of chronic non-healing diabetic wounds under section 1862(a)(1)(A) of the Social Security Act (the Act) for a duration of 20 weeks, when prepared by devices whose Food and Drug Administration-cleared indications include the management of exuding cutaneous wounds, such as diabetic ulcers. C. Nationally Non-Covered Indications Autologous PDGF for the treatment of chronic, non-healing cutaneous wounds, and, Becaplermin, a non-autologous growth factor for chronic, non-healing subcutaneous wounds, and, Autologous PRP for the treatment of acute surgical wounds when the autologous PRP is applied directly to the closed incision, or for dehiscent wounds. D. Other Effective for services performed on or after April 13, 2021: Coverage of autologous PRP for the treatment of chronic non-healing diabetic wounds beyond 20 weeks will be determined by the local Medicare Administrative Contractors (MACs). Coverage of autologous PRP for the treatment of all other chronic non-healing wounds will be determined by the local MACs under section 1862(a)(1)(A) of the Act. (This NCD last reviewed April 2021.)