LCDActive
Platelet Rich Plasma
L39068
Novitas Solutions, Inc. (J12)
Effective: December 12, 2021
Updated: December 31, 2025
Policy Summary
Platelet-rich plasma is covered only when used per NCD 270.3 for blood-derived products in the treatment of chronic non-healing wounds. All other uses of PRP are considered not medically reasonable and necessary and are not covered. Compliance with the LCD may be monitored through post-payment data analysis and medical review audits.
Coverage Criteria Preview
Key requirements from the full policy
"Platelet-rich plasma (PRP) injections and/or applications are covered only when used in accordance with NCD 270."
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