Skin and Soft Tissue Substitutes (CPB 0244, reviewed 2026-07-29)
Summary
Aetna's Clinical Policy Bulletin 0244 sets the coverage rules for skin and soft tissue substitutes used on chronic wounds. Aetna considers these products medically necessary for chronic wounds that failed to respond to treatment when the member is 18 or older, is a non-smoker or has completed or is enrolled in smoking cessation therapy, and the wound is a partial- or full-thickness skin defect of at least 1 cm2 that has not improved after at least four weeks of standard wound care. Diabetic foot ulcers, venous leg ulcers and partial- or full-thickness burn wounds have additional criteria, each listed product has its own indications, and pressure ulcer treatment and other uses are considered not medically necessary, experimental, investigational or unproven.
Get alerts when payers change rules like this one
We check Aetna and other payers every day and email you when a change matches your specialty and state.