Key Points for Skin Substitute Graft Audits in CY 2026
1. According to a report issued by the Office of Inspector General (OIG) in March 2023, Part B expenditures for Skin Substitute Grafts (SSGs), also known as Cellular and/or Tissue-based Products (CTPs), provided in non-institutional settings skyrocketed over the past several years, surpassing $10 billion annually by the end of 2024.
Preparing for Audit Activity in 2026
Each year, the Centers for Medicare & Medicaid Services (CMS) conducts medical reviews (audits) of Medicare Part A/B, Medicaid, and DMEPOS claims in an effort to help lower improper payment rates and protect the Medicare Trust Fund. The wound management industry has long been under scrutiny since the advent of increased coverage for Hyperbaric Oxygen Therapy (HBOT) services in the late 1990's and early 2000's…