Yes. Medicare Part B covers mobile wound care visits when you are homebound or have difficulty traveling to a clinic. Providers must document that in-home care is medically necessary due to mobility limitations. Covered services include wound assessments, treatment, debridement, and dressing changes performed in your home.

The Medicare Part B deductible for 2024 is $240 per year. After the deductible is met, Medicare pays 80% of the approved amount and you pay 20%. If you have a Medigap (Medicare Supplement) plan, it typically covers the 20% coinsurance, resulting in little to no out-of-pocket cost after the deductible.

Yes. Medicare Part B covers amniotic membrane grafts and other cellular- and tissue-based products (CTPs) for chronic wounds that have not healed after at least 30 days of standard care. Coverage requires documentation of medical necessity, failure of conventional treatments, appropriate wound measurements, and use of Medicare-approved products with proper coding.

Medicare does not set a fixed monthly limit on wound care visits. Coverage is based on medical necessity. If weekly or bi-weekly visits are required for debridement, dressing changes, or monitoring, Medicare will cover them when properly documented. Typical care ranges from 1–4 visits per month depending on wound severity.

Yes. Medicare Part B covers wound care for diabetic foot ulcers, including debridement, offloading devices, negative pressure wound therapy, and skin substitutes. Diabetic wound care is considered medically necessary due to the high risk of infection and amputation. Medicare also covers therapeutic shoes and orthotics for eligible diabetic patients.

If a claim is denied, you have the right to appeal. Most denials occur due to incomplete documentation rather than non-covered services. Healix360 providers manage appeals by submitting additional medical records and clinical justification. You are not billed while an appeal is pending unless Medicare issues a final denial after all appeal levels are exhausted.

With Original Medicare (Parts A and B), no referral is required to see a wound care specialist. You may self-refer or be referred by your primary care physician. Some Medicare Advantage plans do require referrals, so plan rules should be verified in advance. Healix360 assists with this during eligibility verification.

Medicare Part B covers wound care supplies when they are applied by a healthcare professional as part of treatment. This includes advanced dressings used during visits. Supplies needed for self-care between visits may require prior authorization or may be covered under Part B Durable Medical Equipment (DME) benefits with separate cost-sharing.

Medicare Part B (Original Medicare) covers 80% of wound care services after the deductible and has no network restrictions. Medicare Advantage plans must cover the same services but may require prior authorization, limit providers to a network, or have different cost-sharing. Some Advantage plans offer extra benefits beyond Part B.

Medicare covers wound care for as long as it is medically necessary and the wound is improving or requires ongoing management. There is no time limit on coverage. Chronic wounds remain covered as long as documentation shows progress or that appropriate alternative treatments are being tried, until the wound heals or reaches maximum medical improvement.