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In the CY 2026 Physician Fee Schedule Proposed Rule, CMS outlines a single national payment rate (~$125.38/cm²) and shifts certain skin-substitute payments to incident-to supplies, changes that could reshape pricing dynamics for placental allografts in physician offices.
Mid-July 2025, policy analysts highlighted CMS’s proposed CY 2026 changes for physician-office use of skin substitutes, including a uniform per-cm² rate (~$125.38) and treating these products as incident-to supplies. While still proposed (not final), the policy aims to curb spending variability and could narrow price differentials among products—especially relevant for placental allografts (amnion/chorion, umbilical cord matrices). If finalized, clinics may re-evaluate product selection based on clinical evidence, handling characteristics, and outcomes rather than price dispersion alone. Stakeholders should monitor the rulemaking process and submit comments before finalization.
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