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Medicare Updates on Skin Substitutes: LCDs Withdrawn, Payment Changes Take Effect

Client Alert
January 23, 2026

Medicare coverage for skin substitutes has seen significant review over the past year. One notable change in coverage for skin substitutes was set to take effect on January 1, 2026, as indicated by the Centers for Medicare and Medicaid Services (“CMS”) announcement released on December 15, 2025.

The announcement indicated that the Medicare Administrative Contractors (“MACs”) were set to release updated Final LCDs for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers. The announcement discussed three categories that the skin substitute products were organized into: (1) Coverage, including products that met the evidence threshold needed for coverage; (2) Non-Covered, including products that lacked submitted evidence showing that the products were “reasonable and necessary” and were without areas of ongoing relevant research; and (3) 12-Month Status Quo Period, indicating that products required further review due to ongoing research. In addition, the announcement listed 18 codes that the MACs identified as covered products, 154 codes subject to MAC discretion, and 158 codes identified as non-covered products.  

On December 24, 2025, CMS announced that the MACs withdrew the Final LCDs. Even though the final LCDs were ultimately withdrawn, the withdrawal is not dispositive of product coverage. Instead, previous coverage rules may still apply. In addition, the Calendar Year 2026 Medicare Physician Fee Schedule Final Rule, which went into effect on January 1, 2026, changed payment for skin substitutes to a single payment rate of app. $127.14.

To learn more about Local Coverage Determinations and Payment Changes for Skin Substitutes, please contact BMD Vice President and Healthcare Member Amanda Waesch at alwaesch@bmdllc.com.     

HealthcareHealth LawMedicareAmanda L. Waesch
Client Alert

FinCEN Residential Real Estate Reporting Rule Now in Effect

March 6, 2026FinCEN’s new Residential Real Estate Reporting Rule, effective March 1, 2026, requires certain real estate transfers to be reported to combat financial crimes. Transfers of residential property to entities or trusts without financing may require a Real Estate Report.Client Alert

Department of Education Proposes Redefinition of “Professional Degree,” Excluding Nursing and Limiting Graduate Loan Borrowing

February 20, 2026The U.S. Department of Education has issued a Notice of Proposed Rulemaking that would redefine “professional degree” programs under the One Big Beautiful Bill Act. The proposal excludes nursing from the recognized list and would impose new borrowing limits for graduate students while eliminating the Grad PLUS program. Public comments are due by March 2, 2026.Client Alert

First-of-Its-Kind Federal Ruling Finds Use of Consumer AI Tool May Destroy Attorney-Client Privilege

February 17, 2026On February 10, 2026, Judge Jed Rakoff of the U.S. District Court for the Southern District of New York issued a first-of-its-kind ruling finding that documents generated by a criminal defendant using a consumer AI platform were not protected by attorney-client privilege after being shared with counsel. The court treated the AI tool as a third party, concluding that entering sensitive information into a publicly available platform may waive confidentiality. The ruling also suggests that the work product doctrine may not apply where AI-generated materials are created independently by a client rather than at counsel’s direction. The decision signals that parties should exercise caution when using consumer AI tools in connection with legal matters.Client Alert

Your Golden Chance for H-1B Lottery Registration - March 2026

February 16, 2026USCIS H-1B registration opens March 4–19, 2026. U.S.-based employees on valid nonimmigrant status are exempt from the $100,000 fee for change of status petitions. The new weighted lottery favors higher-skilled and higher-paid employees, improving odds for advanced degree holders and Wage Level 3 or 4 workers.Client Alert

Invisible Algorithms: The Hidden Role of Artificial Intelligence in USCIS Immigration Processing

February 10, 2026The Department of Homeland Security has confirmed that artificial intelligence and machine learning tools are now integrated into numerous operational functions within U.S. Citizenship and Immigration Services (USCIS). These tools are described as mechanisms to improve efficiency, reduce backlogs, and assist officers in managing an unprecedented volume of applications. DHS emphasizes that human adjudicators retain decision-making authority and that AI systems do not independently grant or deny immigration benefits. Find out how AI affects the U.S. immigration process.
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