The CY2026 Physician Fee Schedule put skin substitutes on a flat national rate per square centimetre. That is not a coding curiosity. It is a change in where the money sits. When every product pays the same, the practice is no longer paid for what it used. It is paid for a visit that can be defended.

Auditors do not start with the invoice. They start with the note. Was a standard-of-care trial documented before the first application? Do the wound measurements and the billed graft units reconcile? Is the repeat application justified under the LCD, or only under habit?

A template that says “wound improved” does not answer those questions. The measurements have to be in the chart. The units have to match the procedure note. The product’s classification has to match the HCPCS that was billed. If any one of those is missing, the claim is not slow. It is exposed.

This is the work our wound-care bench is trained for. Not a general scribe filling a form. A specialist who already knows how this specialty fails an audit, and writes the note so that it does not.