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A2014

PAYER POLICY CHANGES

A2014 Insurance Policy Changes

HCPCS A2014 is officially defined as "Omeza collagen matrix or omeza complete matrix, per 100 mg." HCPCS A2014 is referenced in 8 tracked payer policy changes from Humana, UnitedHealthcare, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A2014 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Humana · Effective Aug 12, 2026High impact
Skin and Tissue Substitutes - MEDICAID - KENTUCKY (Revised)
Humana's revised Kentucky Medicaid policy on skin and tissue substitutes lists the only covered uses as diabetic foot ulcers and venous leg ulcers that have lasted more than 4 weeks, when standard wound care criteria are met, and states that prior authorization is required. The policy lists many HCPCS codes for these products as requiring prior authorization for Humana Healthy Horizons members in Kentucky. The source gives an effective date of 08/12/2026, and the code list in the provided text is cut off near the end.
UnitedHealthcare · Effective Aug 1, 2026High impact
Skin and Soft Tissue Substitutes
This policy revision expands the list of skin and soft tissue substitutes classified as unproven and not medically necessary, adding 20+ product names and their associated HCPCS codes (A2040-A2045, Q4418-Q4440). It also establishes specific coverage criteria for EPIFIX/GRAFIX (limited to diabetic foot ulcers meeting strict requirements) and TransCyte (limited to thermal burn wounds). Billing teams must update claim denial logic and prior authorization rules to reflect these new coverage restrictions effective August 1, 2026.
Humana · Effective May 20, 2026High impact
Skin and Tissue Substitutes - MEDICAID - INDIANA (New)
Humana Indiana Medicaid has established new coverage criteria for skin and tissue substitutes (cellular and acellular matrices) effective May 20, 2026. Coverage is limited to two indications: partial- and full-thickness diabetic foot ulcers (DFU) and chronic venous leg ulcers (VLU), both >4 weeks duration, when used with standard wound therapy and meeting specific clinical prerequisites. All other indications are not covered. This is a historical material discovery—the policy became effective over 4 months prior to analysis date (2026-10-15).
Independence Blue Cross · Effective Apr 1, 2026High impact
MA11.015ag, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Independence Blue Cross Medicare Advantage policy MA11.015ag has been superseded by MA11.015ah, effective 04/01/2026. This update adds 27 new HCPCS codes (A2040-A2045, G0681-G0684, Q4418-Q4440) for bioengineered skin substitutes and revises narratives for codes A2014 and A2037. Billing teams must update systems to recognize these new codes for wound care claims.
Independence Blue Cross · Effective Apr 1, 2026High impact
11.08.20as, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Independence Blue Cross has updated policy 11.08.20as to 11.08.20at, adding 27 new HCPCS codes (A2040–A2045, G0681–G0684, Q4418–Q4440) and revising narratives for codes A2014 and A2037 for bioengineered skin substitutes used in wound care. This expansion broadens coverage options for burns, chronic non-healing wounds, and related conditions effective April 1, 2026.
Humana · Effective May 25, 2026Medium impact
Skin and Tissue Substitutes - MEDICAID - SOUTH CAROLINA (Revised)
South Carolina Medicaid has established new coverage criteria for skin and tissue substitutes, limiting coverage to diabetic foot ulcers and chronic venous leg ulcers that meet specific duration and wound therapy requirements. All other indications for these products are considered not medically necessary.
Humana · Effective May 20, 2026Medium impact
Skin and Tissue Substitutes - MEDICAID - INDIANA (New)
New Indiana Medicaid policy establishes coverage criteria for skin and tissue substitutes specifically for diabetic foot ulcers and chronic venous leg ulcers lasting over 4 weeks when used with comprehensive standard wound therapy. The policy covers numerous HCPCS codes (A2001-A2035, C-codes, Q-codes) but requires strict medical necessity criteria including proper wound assessment, infection treatment, and glycemic control.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Bioengineered Skin and Soft Tissue Substitutes
Several listed tissue-engineered skin substitutes may be considered medically necessary for specific uses, including breast reconstruction with listed acellular dermal matrix products, chronic noninfected full-thickness diabetic lower-extremity ulcers, chronic venous insufficiency ulcers that have not adequately responded to a 1-month period of conventional ulcer therapy, dystrophic epidermolysis bullosa, and second- and third-degree burns. All other uses of the listed products, and all other skin and soft tissue substitutes not listed, are considered investigational. Code reference updates dated 07/01/2026, 08/15/2026 and 10/01/2026 add CPT 1045T through 1049T, HCPCS C9353 and C9361, and HCPCS A2046, A2047, A2048 and A2050 as investigational codes.

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REFERENCE DATA

Payers with rules14

Payers requiring prior auth14

Anthem BCBS · Effective November 1, 2026
Prior authorization required
Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)
Blue Shield of California · Effective November 1, 2026
Prior authorization required
Prior Authorization List for Blue Shield Medicare
Excellus BlueCross BlueShield · Effective October 1, 2026
Prior authorization required
Excellus BCBS utilization management standard clinical review preauthorization list

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for A2014?

Ambetter lists A2014 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for A2014?

AmeriHealth Caritas lists A2014 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for A2014?

Anthem BCBS lists A2014 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for A2014?

BCBS Illinois lists A2014 on Utilization Management Process for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for A2014?

BCBS New Mexico lists A2014 on Medicare Advantage Prior Authorization Procedure Code List for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS A2014?

There are 8 tracked policy changes affecting HCPCS A2014, including updates from Humana, UnitedHealthcare, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS A2014?

Payers that have issued tracked updates for HCPCS A2014 include: Humana, UnitedHealthcare, Independence Blue Cross, Blue Cross & Blue Shield of Mississippi.

How do I get notified when HCPCS A2014 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A2014. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS A2014?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for A2014

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for A2014 in one place.

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All billing codes J3590 C9399 J3490 99215 99213 99202

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Skin and Tissue Substitutes - MEDICAID - KENTUCKY (Revised)

Skin and Soft Tissue Substitutes

Skin and Tissue Substitutes - MEDICAID - INDIANA (New)

MA11.015ag, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds

11.08.20as, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds

Skin and Tissue Substitutes - MEDICAID - SOUTH CAROLINA (Revised)

Skin and Tissue Substitutes - MEDICAID - INDIANA (New)

Bioengineered Skin and Soft Tissue Substitutes

Prior authorization required

Prior authorization required

Prior authorization required

Does Ambetter require prior authorization for A2014?

Does AmeriHealth Caritas require prior authorization for A2014?

Does Anthem BCBS require prior authorization for A2014?

Does BCBS Illinois require prior authorization for A2014?

Does BCBS New Mexico require prior authorization for A2014?

What insurance policy changes affect HCPCS A2014?

Which payers have updated policy for HCPCS A2014?

How do I get notified when HCPCS A2014 policy changes?

Why do payers change policies for HCPCS A2014?