APWCA News

The American Professional Wound Care Association is proud to announce new specialty interest groups. Please see the categories below led by APWCA Board Members:

To join a specialty interest group, log in to your APWCA profile at apwca.org to edit your profile. Find the field labeled 'Special Interest Group'. Here you can choose which special interest group(s) you would like to join. You may join more than one special interest group.

Once logged in to the APWCA website, members can view all specialty group discussion boards. Go under the 'Member Portal' tab and click on 'Specialty Interest Groups'. From here you will find the links to each discussion board. You must select your specialty interest group(s) in your APWCA member profile to post in your specialty group(s). 

Your APWCA collaborated with the Alliance of Wound Care Stakeholders on a comment letter to the Centers for Medicare and Medicaid Services (CMS) in response to the 2021 Proposed Physician Fee schedule. In this letter we asked CMS to apply the new, increased values of certain E/M codes to the values of global procedures.

Your APWCA collaborated with the Alliance of Wound Care Stakeholders on a comment letter to the Centers for Medicare and Medicaid Services (CMS) in response to the 2021 Proposed Physician Fee schedule. In this letter we opposed proposed cuts in reimbursement to certain surgical procedures and physical therapy services.

The APWCA collaborated with the Alliance of Wound Care Stakeholders in submitting a letter to the Centers for Medicare and Medicaid Services (CMS) DME Contractors disagreeing with preliminary determination to not cover topical oxygen therapy for would healing, urging the DME MACs to consider the available evidence on a per wound-type basis and make wound type-specific coverage determinations.

APWCA collaborated with the Alliance of Wound Care Stakeholders in submitting a letter to the Centers for Medicare and Medicaid Services (CMS) flagging the differing interpretations of the three payment methodologies that CMS has been considering in HOPD / ASC proposed rule making regarding payment for skin substitutes / CTPs. We specified our understanding of each methodology and outlined issues to consider for each methodology. This was all done with advocacy for our members and our patients in mind.

APWCA collaborated with the Alliance of Wound Care Stakeholders to submit comments to the Centers for Medicare and Medicaid Services (CMS) that requested the following waivers be initiated during the COVID-19 Public Health Emergency:

• Relax documentation needed for advanced wound products prior to initiation of these therapies
• Relax the definition of a “qualifying wound” as it pertains to coverage for Surgical Dressings
• Allow an overlap of coverage within the two separate benefits of Part A and Part B
• Allow reimbursement for DME Removable Cast Walkers (HCPCS L4361 and L4387) for patients with diabetic foot ulcers when other methods of offloading are not feasible

APWCA collaborated with the Alliance of Wound Care Stakeholders to submit comments to the Centers for Medicare and Medicaid Services (CMS) that supported the following COVID-19 provisions:

• Reimbursement for telehealth at the non-facility rate, as appropriate, when submitted with a 95 modifier and the place of service corresponding to where that service would have been provided had the service been rendered in person
• Expansion of telehealth services generally
• Choice of medical decision making or total time when determining the level of office/outpatient E/M furnished via telehealth
• Ability to provide virtual check-ins, telephone E/Ms, and e-visits to both new and established patients;
• Ability to provide direct supervision via real time interactive audio and video technology; and
• Coverage and payment for telephone evaluation and management services

APWCA representation participated in a Noridian Healthcare Solutions Contractor Advisory Committee meeting regarding development of their “Wound Care and Skin Substitutes” Local Coverage Determination / Local Coverage Article. Noridian does not currently have an active “Wound Care and Skin Substitutes” Local Coverage Determination / Local Coverage Article, and APWCA was present at this meeting to protect the interests of our members and our patients as these policies are developed. Noridian Part B administers Medicare services in California, Nevada, Oregon, Washington, Idaho, Utah, Arizona, Montana, Wyoming, North Dakota, South Dakota, Alaska, and Hawaii.

APWCA Members Minute with Elizabeth Faust

Over the last month, your APWCA leaders have collaborated with the Alliance of Wound Stakeholders and other organizations on communication with the Centers for Medicare and Medicaid Services (CMS) regarding payment methodology for cellular and/or tissue based products for wounds (CTPs) provided in Hospital Outpatient Departments and Ambulatory Surgery Centers. CMS has expressed an interest in changing the current bundled payment mythology for these services and our communication has focused on protecting the interests of our members and our patients.