MiMedx Group, Inc. Supports Proposed Medicare Reimbursement Reform for Skin Substitutes in CY 2026 Physician Fee Schedule

MiMedx supports CMS's proposed fixed-price reimbursement for skin substitutes, advocating for market reform and improved patient care.

Quiver AI Summary

MiMedx Group, Inc. has expressed its support for the Centers for Medicare and Medicaid Services' (CMS) proposal in the 2026 Physician Fee Schedule to change Medicare's reimbursement methodology for skin substitutes from the Average Selling Price to a fixed price of $125.38 per square centimeter. CEO Joseph H. Capper highlighted that while the proposed price may be contentious, reform is necessary to address the rapid increase in Medicare spending on skin substitutes, which soared from $1.5 billion in 2022 to nearly $10 billion in 2024 due to unsavory business practices. Capper emphasized the importance of reimbursement reform in reducing fraud and inefficiency, benefitting stakeholders and patients alike. MiMedx plans to share feedback during the comment period and is preparing for changes set for implementation in January 2026, while pursuing its mission of providing innovative healing solutions in wound care.

Potential Positives

MiMedx supports the proposed Medicare reimbursement reform for skin substitutes, which aims to address inefficiencies and fraud within the marketplace.
The proposed fixed price per square centimeter for skin substitutes could lead to a more rational market behavior and benefit stakeholders, taxpayers, and patients.
MiMedx is positioned to excel in this evolving environment, leveraging its robust clinical evidence and product capabilities.

Potential Negatives

Concerns about the proposed reimbursement price of $125.38 per square centimeter for skin substitutes may indicate that the company could face challenges in maintaining profitability within its product line.
The significant increase in Medicare spending on skin substitutes from approximately $1.5 billion in 2022 to nearly $10 billion in 2024 raises alarms about potential scrutiny and regulatory pressures on the industry, affecting MiMedx’s operations.
References to "unsavory business practices" and "fraud, waste and abuse" could damage the reputation of the industry and the company as associated with these negative practices, impacting stakeholder trust.

FAQ

What are the key changes in the CY 2026 Physician Fee Schedule proposal?

The proposal suggests a fixed price of $125.38 per square centimeter for all skin substitutes, moving away from the ASP methodology.

How does MIMEDX respond to the proposed Medicare reimbursement changes?

MIMEDX supports the proposed reimbursement reform and believes it will benefit stakeholders, taxpayers, and patients by reducing fraud and waste.

When does the comment period for the new PFS rules end?

The comment period for the CY 2026 Physician Fee Schedule proposal concludes on September 13, 2025.

What is the WISeR model mentioned in the press release?

The Wasteful and Inappropriate Service Reduction (WISeR) model aims to reform reimbursement practices and improve healthcare delivery in skin substitutes.

When will the CY 2026 Hospital Outpatient Prospective Payment System be released?

The CY 2026 Hospital Outpatient Prospective Payment System is expected to be published in proposed form and take effect on January 1, 2026.

Disclaimer: This is an AI-generated summary of a press release distributed by GlobeNewswire. The model used to summarize this release may make mistakes. See the full release here.

$MDXG Insider Trading Activity

$MDXG insiders have traded $MDXG stock on the open market 8 times in the past 6 months. Of those trades, 1 have been purchases and 7 have been sales.

Here’s a breakdown of recent trading of $MDXG stock by insiders over the last 6 months:

JOSEPH H CAPPER (Chief Executive Officer) purchased 200,000 shares for an estimated $1,268,000
WILLIAM FRANK IV HULSE (General Counsel and CAO) has made 0 purchases and 3 sales selling 136,042 shares for an estimated $1,066,041.
RICCI S WHITLOW (Chief Operating Officer) sold 61,420 shares for an estimated $508,557
KIMBERLY MAERSK-MOLLER (Chief Commercial Officer) has made 0 purchases and 3 sales selling 7,976 shares for an estimated $64,281.

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$MDXG Hedge Fund Activity

We have seen 92 institutional investors add shares of $MDXG stock to their portfolio, and 87 decrease their positions in their most recent quarter.

Here are some of the largest recent moves:

CANNELL CAPITAL LLC removed 1,506,585 shares (-41.4%) from their portfolio in Q1 2025, for an estimated $11,450,046
MILLENNIUM MANAGEMENT LLC added 596,016 shares (+93.9%) to their portfolio in Q1 2025, for an estimated $4,529,721
BLACKROCK, INC. added 582,644 shares (+6.1%) to their portfolio in Q1 2025, for an estimated $4,428,094
MEROS INVESTMENT MANAGEMENT, LP added 425,531 shares (+107.7%) to their portfolio in Q1 2025, for an estimated $3,234,035
PHOCAS FINANCIAL CORP. added 380,014 shares (+1193.8%) to their portfolio in Q1 2025, for an estimated $2,888,106
D. E. SHAW & CO., INC. added 363,630 shares (+149.7%) to their portfolio in Q1 2025, for an estimated $2,763,588
MARSHALL WACE, LLP removed 348,747 shares (-100.0%) from their portfolio in Q1 2025, for an estimated $2,650,477

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$MDXG Analyst Ratings

Wall Street analysts have issued reports on $MDXG in the last several months. We have seen 1 firms issue buy ratings on the stock, and 0 firms issue sell ratings.

Here are some recent analyst ratings:

Cantor Fitzgerald issued a "Overweight" rating on 02/27/2025

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Full Release

MARIETTA, Ga., July 15, 2025 (GLOBE NEWSWIRE) -- MiMedx Group, Inc. (Nasdaq: MDXG) (“MIMEDX” or the “Company”) today commented on the Centers for Medicare and Medicaid Services (“CMS”) release of the CY 2026 Physician Fee Schedule (“PFS”) proposal.

“We welcome and support improvements to Medicare’s reimbursement of skin substitutes across all care settings. The proposed rule, which was published yesterday afternoon, calls for a move away from the ASP methodology in favor of a fixed price per square centimeter of $125.38 for all skin substitutes. While many may take issue with the proposed price, reform in this category is long overdue,” stated Joseph H. Capper, MIMEDX Chief Executive Officer.

Mr. Capper continued, “The skin substitute market has experienced a proliferation of unsavory business practices over the last several years, as referenced in several recently announced enforcement actions. Under the current reimbursement methodology, the 2024 Medicare spend for skin substitutes in the private office and associated care settings had ballooned to nearly $10 billion, up from approximately $1.5 billion in 2022. Reimbursement reform that restores rational market behavior and diminishes fraud, waste and abuse will serve to benefit stakeholders, taxpayers and, most importantly, patients. We look forward to providing our perspective and recommendations to CMS during the upcoming comment period, which concludes on September 13, 2025. As always, we remain focused on supporting our customers and their patients as they navigate this evolving landscape.”

“Importantly, MIMEDX is well-positioned to excel in an environment in which product capabilities, supported by robust clinical evidence, determine selection and usage. The recently announced Wasteful and Inappropriate Service Reduction (“WISeR”) model, the pending Local Coverage Determinations (“LCDs”), and now the PFS rules are all set for implementation on January 1, 2026. We plan to discuss this topic in more detail on our upcoming second quarter earnings call,” concluded Mr. Capper.

The CY 2026 Hospital Outpatient Prospective Payment System (“OPPS”), while mentioned extensively in the PFS, has not yet been published but is also expected to be released in proposed form and slated for implementation on January 1, 2026.

About MIMEDX
MIMEDX is a pioneer and leader focused on helping humans heal. With more than a decade of helping clinicians manage chronic and other hard-to-heal wounds, MIMEDX provides a leading portfolio of products for applications in the wound care, burn, and surgical sectors of healthcare. The Company’s vision is to be the leading global provider of healing solutions through relentless innovation to restore quality of life. For additional information, please visit www.mimedx.com .

Contact:
Matt Notarianni
Investor Relations
470-304-7291
[email protected]