Kerecis MariGen
U.S. Reimbursement
Hospital Outpatient Department
Kerecis® MariGen is reimbursed by Medicare and has wide coverage through private insurers. Kerecis® MariGen is available in Veterans Administration hospitals and is on the Federal Supply Schedule in all Veterans Integrated Service Networks (VISNs).®
Kerecis® MariGen is reimbursed by Medicare in the high cost group for applications of skin substitutes in the HOPD setting using CPT codes 15271-15278.
Medicare payment for Q4158 – Kerecis® MariGen is included in the payment for the application.
The Medicare National Payment rate for high cost group in 2024 is $1,737.53 in a Hospital Outpatient setting for wounds less than 100 sq cm (site of service 22).
Kerecis MariGen Expanse expands to over 100 sq cm to economically treat large wounds in the HOPD Setting.
Kerecis Expanse utilizes Q4158. The Medicare National Payment rate in 2024 for CPT 15273: Wounds over 100 sq cm is $3,418.26
Ambulatory Surgical Center
Kerecis® MariGen is reimbursed in the high cost group for applications of skin substitutes in the ASC setting using CPT codes 15271-15278.
Medicare payment for Q4158 – Kerecis® MariGen is included in the payment for the application. The Medicare National Payment rate for high cost group in 2024 is $945.97 in a Freestanding Ambulatory Surgical Center (site of service 24).
Physician’s Office Setting
Kerecis has separate reimbursement for MariGen, Q4158, and Shield Adhesive, A2019, if applied in a physician’s office (site of service 11).
Contact the Reimbursement Hotline at 844-KERECIS (844-537-3247) for Benefit Investigation and fee schedule information.
Reimbursement Hotline and Benefit Verification
Once you decide to use Kerecis® MariGen, our Reimbursement Hotline team will work closely with you throughout your benefit verification and prior authorization and update you on the policy status of Kerecis in your area.
If you have any questions about reimbursement for Kerecis® MariGen, contact us:
Email: reimbursement@kerecis.com
Reimbursement Hotline: 844-KERECIS (844-537-3247)
Fax: 844-529-3247
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