💳 Insurance & Reimbursement

Insurance Coverage Hub

Everything you need to know about insurance coverage, reimbursement, and billing for collagen wound care products

98% Reimbursement Success Rate

We handle all insurance verification, prior authorizations, and billing for you

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Medicare

Part B covers medically necessary wound care supplies

  • ✓ Chronic wound coverage
  • ✓ 80% coverage after deductible
  • ✓ Direct billing available
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Medicaid

Coverage available in all 50 states

  • ✓ State-specific programs
  • ✓ Often $0 patient cost
  • ✓ PA assistance included
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Commercial

Major insurers follow Medicare guidelines

  • ✓ BCBS, UHC, Aetna, Cigna
  • ✓ 80-100% coverage typical
  • ✓ Pre-verification provided

HCPCS Billing Codes

Standard codes for collagen wound care products - accepted by all major insurers

A6010

Collagen Powder

Per gram of dry weight

A6021

Collagen Sheet ≤16 sq in

2×2, 3×3 sizes

A6210

Collagen Sheet >16-48 sq in

4×4, 4×5 sizes

Documentation Requirements

For Physicians

  • Wound Assessment

    Measurements, stage/classification, location

  • ICD-10 Diagnosis

    Primary wound diagnosis code

  • Treatment Plan

    Product selection, frequency, duration

  • Progress Notes

    Weekly wound status documentation

What We Handle

  • Insurance Verification

    We verify coverage before shipping

  • Prior Authorization

    Complete PA process (3-5 days)

  • Claims Submission

    Direct billing to insurance

  • Appeals Management

    Handle denials and resubmissions

Coverage by Insurance Type

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Medicare Part B

Covers collagen dressings for chronic wounds when medically necessary

Covered Conditions:

  • • Pressure ulcers (Stage II-IV)
  • • Diabetic foot ulcers
  • • Venous stasis ulcers
  • • Arterial ulcers
  • • Surgical wounds

Patient Cost:

20% coinsurance after Part B deductible ($240 in 2025)

Typical cost: $5-15 per order

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Medicaid

State programs cover wound care supplies with varying requirements

Coverage Details:

  • • Available in all 50 states
  • • Prior authorization often required
  • • State-specific formularies
  • • We manage state variations

Patient Cost:

Typically $0 out-of-pocket

Some states have small copays ($1-5)

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Commercial Insurance

Major insurers including Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna

General Coverage:

  • • Follow Medicare guidelines
  • • Prior auth requirements vary
  • • In-network benefits
  • • DME benefits typically apply

Patient Cost:

80-100% coverage after deductible

Typical: $10-30 copay

Questions About Your Coverage?

Our reimbursement specialists are here to help verify your insurance and answer any questions

Additional Resources