Medical Policies

Published 1/1/2018

The Centers for Medicare and Medicaid Services (CMS) assigns Medicare Administrative Contractors (MACs) the task of developing Local Coverage Determinations (LCDs) to describe reasonable and necessary services within the Medicare program. The LCD process as described in the Medicare Program Integrity Manual (PIM), Chapter 13 (PDF, 124 KB) provides requirements for submission and review of new LCD requests, LCD reconsideration requests, and the opportunity to request an informal meeting to ensure all required documentation is correctly submitted to the MAC upon submission of your request. A list of LCDs can be found under LCDs, NCDs, Coverage Articles. This page also includes a table of all active LCDs, related articles to the LCD, and applicable CPT/HCPCS codes.

The PIM, Chapter 13 discusses information regarding LCD development meetings described as Contractor Advisory Committee (CAC) Meetings and Open Meetings. Information regarding past and upcoming meetings can found under LCD Development Meetings or by clicking on one of the icons above.

CMS assigns MACs the task of developing coverage articles that give direction on how to bill or code for a service or to provide education on a specific topic.  A list of Medicare Coverage Database (MCD) articles can be found under LCDs, NCDs, Coverage Articles. This page also includes a table of all active MCD articles, the related LCD (if applicable), and applicable CPT/HCPCS codes.

National Coverage Determinations (NCDs) are owned and maintained by CMS. A list of NCDs and a link on how to request reconsideration of an NCD can be found under LCDs, NCDs, Coverage Articles.

JJ Open Meeting Held on November 2, 2020Jurisdiction J (JJ) Open Meeting Agenda: June 1, 2020Jurisdiction J Open Meeting Notification - Proposed LCD(s) Released for CommentJurisdiction J (JJ) Open Meeting Agenda: October 7, 2019Open Meeting: October 7, 2019Open Meeting: May 6, 2019JJ Open Meeting Held on June 1, 2020Multi-Jurisdictional Pharmacogenomics in Psychiatry CAC Meeting Recording: June 26, 2019Multi-jurisdictional CAC Meeting: LCD Evidentiary Discussion Regarding Facet Joint and Medial Nerve Branch Procedures - May 28th, 2020Jurisdiction J (JJ) Open Meeting Agenda: May 6, 2019Jurisdiction J (JJ) Open Meeting Agenda: November 2, 2020Contractor Advisory Committee Meeting Announcement: January 11, 2021February 11, 2021, Multi-Jurisdictional Contractor Advisory Committee (CAC)/Subject Matter Expert Meeting regarding Epidural Interventions for Chronic Pain ManagementCardiac Resynchronization Therapy Contractor Advisory Committee (CAC) March 23, 2021, Meeting: Transcript and RecordingAmniotic Product Injections for Musculoskeletal Indications, Non-Wound Contractor Advisory Committee (CAC) Meeting: May 12, 2021JJ Open Meeting: June 28, 2021Jurisdiction J (JJ) Open Meeting: August 2, 2021Postpayment Service-Specific Probe Results for Outpatient Rehabilitation Services and Therapeutic Exercises for October through December 2020Multi-Jurisdictional Moldx: Molecular Testing For Risk Stratification of Upper Gastrointestinal Cancer Contractor Advisory Committee (CAC): October 12, 2021Multi-Jurisdictional MolDX: Predictive Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis Contractor Advisory Committee (CAC): December 7, 2021JJ Open Meeting: November 1, 2021JJ Open Meeting: March 28, 2022Enforcement Delay - MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing L38988Multi-Jurisdictional Sacroiliac Joint Injections and Procedures Contractor Advisory Committee Meeting: March 10, 2022MolDX Open Meeting: May 10, 2022JJ Open Meeting: May 9, 2022MoIDX Open Meeting: August 1, 2022