What is WiSER and how WoundScribe can help

Starting January 2026, CMS is running a six-year demonstration called WISeR — Wasteful and Inappropriate Service Reduction — in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. It uses AI screening plus licensed clinician review to confirm selected Medicare Part B services are appropriate before payment. Coverage rules haven't changed. The timing has. ### What's actually under review Three anchor service categories are in scope, and CMS can add more: - Skin and tissue substitutes for chronic wounds - Electrical nerve stimulator implants - Knee arthroscopy for osteoarthritis For wound and podiatry clinics, skin substitutes are where WISeR bites hardest. Reviewers expect a qualifying diagnosis, documented conservative care, serial measurements, correct product and units, and patient-specific medical necessity. ### How the two pathways work You either submit prior authorization first and get a decision in days, or skip it and have your claim auto-routed to pre-payment review. The review is unavoidable — only the timing is your choice. Standard decisions return within three business days, expedited within two. A non-affirmation is usually a documentation gap, not a coverage problem, and most are resolved by resubmission. ### Where WoundScribe carries the load WISeR is a documentation test. Templated notes that could describe any patient are the number-one reason good care gets rejected. Specifics like "DFU right plantar, 3.2 by 2.1 cm" earn affirmations. That's exactly what WoundScribe builds — patient-specific rationale through image-anchored capture, code validation against NCDs and LCDs, and formatting for all six CMS-selected reviewers. Sustain roughly 90% affirmation across ten requests and quarterly reviews can waive prior authorization entirely under Gold Card. Ready to prepare? Start with the WISeR readiness checklist or explore the WoundScribe WISeR Program.