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Excellus BlueCross BlueShieldCommercial · Coverage · Skin (Dermatology) · Dermatology, Wound Care, PodiatryMedium impact

Platelet Rich Plasma and Growth Factor Treatments 2.01.24

Effective date
Jan 22, 2026
Identified
Jun 20, 2026

Summary

Policy 2.01.24, Platelet Rich Plasma and Growth Factor Treatments, states that platelet-rich plasma (PRP) and autologous platelet-derived preparations, including basic fibroblast growth factor, epidermal growth factor, and placental angiogenic growth factors, are investigational for all indications. The 01/22/26 annual update changed the policy title and deleted the policy statements for becalpermin gel. The policy also states that the AAOS guidelines for osteoarthritis of the hip and glenohumeral joint, and for rotator cuff injuries, do not recommend PRP for these conditions.

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What to do

Action · 3 steps
01Already effective January 22, 2026: Billing team, the policy lists CPT 0232T, HCPCS G0460, G0465, P9020, and S9055 as (E/I) experimental or investigational.
02G0465 applies to diabetic chronic wounds and ulcers using an FDA-cleared device, and G0460 applies to nondiabetic chronic wounds and ulcers.
03Services are contract dependent: if a product does not cover a service, the medical policy criteria do not apply, and if a commercial product covers a specific service, the medical policy criteria apply to that benefit.

Codes mentioned

G0460G0465P9020S9055E08.621E08.622E09.621E09.622E10.621E10.622E11.621E11.622E13.621E13.622

Original notice

Platelet Rich Plasma and Growth Factor Treatments 2.01.24
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesDermatologyWound CarePodiatryCode G0460Code G0465Code P9020Code S9055Code E08.621Code E08.622Code E09.621Code E09.622Code E10.621Code E10.622Code E11.621Code E11.622Code E13.621Code E13.622

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