Congress Examines Medicare's Wound Care Billing Crisis as Skin Substitute Spending Topped 14 Billion Dollars

A House Oversight subcommittee held a roundtable on July 21 titled "Medicare Fraud: Examining the Explosive Growth in Skin Substitute Spending," putting one of the program's fastest-growing cost categories under congressional review. According to the subcommittee's materials, Medicare spending on skin substitute procedures climbed from approximately 200 million dollars in 2019 to more than 14.4 billion dollars in 2025, a roughly 7,100 percent increase over six years. Skin substitutes are biologic or synthetic products applied to chronic wounds such as diabetic ulcers and venous leg ulcers and are billed under Medicare Part B. A September 2025 report from the HHS Office of Inspector General had already flagged the trend, finding that Part B payments for these products grew from under 400 million dollars in 2022 to over 10 billion dollars in 2024. The OIG identified patterns it associated with fraud risk, including use of skin substitutes on a patient's first visit without any prior conservative treatment and disproportionately high use in home care settings relative to office visits. CMS restructured its payment methodology for skin substitutes starting January 1, 2026, as part of the Physician Fee Schedule update for that year. The roundtable, led by Representative Glenn Grothman, examined how fraud schemes operate in the wound care space, why Medicare became vulnerable to such rapid spending growth, and what additional steps Congress and federal agencies might take beyond the 2026 payment changes.