CMS to Cover Blood-Derived Products for Chronic, Non-Healing Wounds

The Centers for Medicare and Medicaid Services (CMS) will cover autologous platelet-rich plasma for the treatment of chronic non-healing wounds effective April 13, 2021. In a revised national coverage determination (NCD) issued on Jan. 20, 2022, CMS announced that it had added the following two codes to the Medicare Physician Fee Schedule Database (MPFSDB) and HCPCS file:

• HCPCS G0460 (Autologous PRP for non-diabetic chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment). 
• HCPCS G0465 (Autologous PRP for diabetic chronic wounds/ulcers, using an FDA-cleared device for this indication, including administration, dressings, phlebotomy, centrifugation and all other preparatory procedures, per treatment).

The codes are effective retroactive back to the effective date of the policy.

In January, AABB registered its support of the then-proposed decision memo and recommended that CMS recognize standards-setting and accreditation organizations, including AABB, to ensure the safety and quality of these treatments.