US · guidance
CMS Pub. 100-04, ch. 32, § 11.3.1
Policy
Effective for claims with dates of service on or after April 13, 2021, contractors shall accept and pay for autologous
platelet-rich plasma (PRP) for the treatment of chronic non-healing diabetic wounds 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, in accordance with the coverage criteria outlined in Publication 100-03,
chapter 1, section 270.3, of the National Coverage Determinations (NCD) Manual.
NOTE: Coverage of PRP services for the treatment of chronic non-healing diabetic wounds that are performed more
than 20 weeks after the date of the first PRP service shall be determined by the local Medicare Administrative
Contractor (MAC).
Coverage of autologous PRP for the treatment of all other chronic non-healing wounds (non-diabetic) will be
determined by local MACs under section 1862(a)(1)(A) of the Social Security Act.
History
(Rev. 11214, Issued: 01-20-22, Effective:04-13-21, Implementation: 01-03-22 Shared Systems Contractors, 02- 14-22 MACs)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
8916c2b7d0f9cdc54fe80c963aa8439d1453530cc2a3b45a2afb4310d9b54294
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