Skin and Tissue Substitutes - MEDICAID - FLORIDA

This Florida Medicaid policy covers skin and tissue substitutes (e.g., Apligraf, Dermagraft, Biobrane, AlloDerm/DermACELL, Grafix, Epifix and others) for treatment of partial‑ and full‑thickness wounds, pressure and venous ulcers, diabetic foot ulcers, burns, and specified uses in breast reconstruction and hernia repair. Major limitations include product‑specific indications: most ulcer treatments require >4 weeks’ duration and inadequate response to standard wound therapy, no exposure of bone/capsule/muscle/tendon, Apligraf is limited to noninfected ulcers with venous ulcers requiring compression, several grafts are restricted to use only with covered breast reconstruction, and coverage is subject to member plan terms and medical director review.

"Hernia repair"

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