Local Coverage Determinations

Local Coverage Determinations

What is an LCD?

Local coverage determinations (LCDS) are defined in Section 1869(f)(2)(B) of the Social Security Act (the Act). This section states: “For purposes of this section, the term ‘local coverage determination' means a determination by a fiscal intermediary or a carrier under part A or part B, as applicable, respecting whether or not a particular item or service is covered on an intermediary- or carrier-wide basis under such parts, in accordance with section 1862(a)(1)(A).”

Upcoming Meetings

DateMAC/JurisdictionLocationIssues/Topics
October 17, 2024 (PDF)
3:00 – 5:00 PM ET/ 2:00- 4:00 PM CT
Multi-Jurisdictional CAC Meeting 
(hosted by NGS)
-Noridian, JE/JF
-WPS, J5/J8
-CGS
Webex TeleconferenceSuperficial Radiation Therapy (SRT) for the Treatment of Nonmelanoma Skin Cancers (NMSC)
October 23, 2024 (PDF)
1:00 PM CT – 3:00 PM CT (2:00 Pm – 4:00 PM ET)
WPS/J5,J8WebinarFall Proposed LCDs – Molecular Diagnostics (MolDX)
October 24, 2024 (PDF)
12:00 – 2:00 PM ET/ 11:00- 1:00 PM CT
NGS, J6/JKWebex Teleconference
  • Pharmacogenomics Testing
  • Molecular Pathology Procedures
  • Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases
  • Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
October 24, 2024 (PDF)
5:00 PM CT – 7:00 PM CT (6:00 Pm – 8:00 PM ET)
WPS/J5,J8WebinarFall Proposed LCDs – Molecular Diagnostics (MolDX)
October 29, 2024 (PDF)
4-5 PM ET
CGS, J15 KYOnsite and Teleconference/Webinar via Microsoft Teams
  • MolDX: Genetic Testing for Heritable Thoracic Aortic Disease
  • MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
  • MolDX: Molecular Testing for Identification and Management of Hereditary Transthyretin Amyloidosis
  • Intravertebral Disc Injections (Via Disc) 0627T
  • Non-invasive Vascular (open to revised section only)
October 30, 2024 (PDF)
4-5 PM ET
CGS, J15 OHOnsite and Teleconference/Webinar via Microsoft Teams
  • MolDX: Genetic Testing for Heritable Thoracic Aortic Disease
  • MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
  • MolDX: Molecular Testing for Identification and Management of Hereditary Transthyretin Amyloidosis
  • Intravertebral Disc Injections (Via Disc) 0627T
  • Non-invasive Vascular (open to revised section only)

Click the date for more information on each meeting

Medicare Administrative Contractors

A / C / D / F / G / H / I / K / L / M / N / O / P / R / S / T / U / V / W

StateJurisdiction (J)Medicare Administrative Contractor (MAC)
Alabama

DME MAC - JC

A/B MAC - JJ

HH + H MAC - JM

CGS Administrators, LLC

Palmetto GBA, LLC

Palmetto GBA, LLC

Alaska

DME MAC - JD

A/B MAC - JF

HH+ H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

American Samoa

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Arizona

DME MAC - JD

A/B MAC - JF

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Arkansas

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

California

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Colorado

DME MAC - JC

A/B MAC - JH

HH + H MAC - J15

CGS Administrators, LLC

Novitas Solutions, Inc.

CGS Administrators, LLC

Connecticut

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

Delaware

DME MAC - JA

A/B MAC - JL

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Novitas Solutions, Inc.

CGS Administrators, LLC

District of Columbia

DME MAC - JA

A/B MAC - JL

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Novitas Solutions, Inc.

CGS Administrators, LLC

Florida

DME MAC - JC

A/B MAC - JN

HH + H MAC - JM

CGS Administrators, LLC

First Coast Service Options, Inc.

Palmetto GBA, LLC

Georgia

DME MAC - JC

A/B MAC - JJ

HH + H MAC - JM

CGS Administrators, LLC

Palmetto GBA, LLC

Palmetto GBA, LLC

Guam

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Hawaii

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Idaho

DME MAC - JD

A/B MAC - JF

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Illinois

DME MAC - JB

A/B MAC - J6

HH + H MAC - JM

CGS Administrators, LLC

National Government Services, Inc.

Palmetto GBA, LLC

Indiana

DME MAC - JB

A/B MAC - J8

HH + H MAC - JM

CGS Administrators, LLC

Wisconsin Physicians Service Government Health Administrators

Palmetto GBA, LLC

Iowa

DME MAC - JD

A/B MAC - J5

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Wisconsin Physicians Service Government Health Administrators

CGS Administrators, LLC

Kansas

DME MAC - JD

A/B MAC - J5

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Wisconsin Physicians Service Government Health Administrators

CGS Administrators, LLC

Kentucky

DME MAC - JB

A/B MAC - J15

HH + H MAC - JM

CGS Administrators, LLC

CGS Administrators, LLC

Palmetto GBA, LLC

Louisiana

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

Maine

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

Maryland

DME MAC - JA

A/B MAC - JL

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Novitas Solutions, Inc.

CGS Administrators, LLC

Massachusetts

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

Michigan

DME MAC - JB

A/B MAC - J8

HH + H MAC - J6

CGS Administrators, LLC

Wisconsin Physicians Service Government Health Administrators

National Government Services, Inc.

Minnesota

DME MAC - JB

A/B MAC - J6

HH + H MAC - J6

CGS Administrators, LLC

National Government Services, Inc.

National Government Services, Inc.

Mississippi

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

Missouri

DME MAC - JD

A/B MAC - J5

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Wisconsin Physicians Service Government Health Administrators

CGS Administrators, LLC

Montana

DME MAC - JD

A/B MAC - JF

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

CGS Administrators, LLC

Nebraska

DME MAC - JD

A/B MAC - J5

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Wisconsin Physicians Service Government Health Administrators

CGS Administrators, LLC

Nevada

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

New Hampshire

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

New Jersey

DME MAC - JA

A/B MAC - JL

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Novitas Solutions, Inc.

National Government Services, Inc.

New Mexico

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

New York

DME MAC - JA

A/B MAC - JK

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

North Carolina

DME MAC - JC

A/B MAC - JM

HH + H MAC - JM

CGS Administrators, LLC

Palmetto GBA, LLC

Palmetto GBA, LLC

North Dakota

DME MAC - JD

A/B MAC - JF

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

CGS Administrators, LLC

Northern Mariana Islands

DME MAC - JD

A/B MAC - JE

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Ohio

DME MAC - JB

A/B MAC - J15

HH + H MAC - JM

CGS Administrators, LLC

CGS Administrators, LLC

Palmetto GBA, LLC

Oklahoma

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

Oregon

DME MAC - JD

A/B MAC - JF

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

Pennsylvania

DME MAC - JA

A/B MAC - JL

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Novitas Solutions, Inc.

CGS Administrators, LLC

Puerto Rico

DME MAC - JC

A/B MAC - JN

HH + H MAC - J6

CGS Administrators, LLC

First Coast Service Options, Inc.

National Government Services, Inc.

Rhode Island

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

South Carolina

DME MAC - JC

A/B MAC - JM

HH + H MAC - J M

CGS Administrators, LLC

Palmetto GBA, LLC

Palmetto GBA, LLC

South Dakota

DME MAC - JD

A/B MAC - JF

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

CGS Administrators, LLC

Tennessee

DME MAC - JC

A/B MAC - JJ

HH + H MAC - JM

CGS Administrators, LLC

Palmetto GBA, LLC

Palmetto GBA, LLC

Texas

DME MAC - JC

A/B MAC - JH

HH + H MAC - JM

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

Utah

DME MAC - JD

A/B MAC - JF

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

CGS Administrators, LLC

Vermont

DME MAC - JA

A/B MAC - JK

HH + H MAC - JK

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

National Government Services, Inc.

Virgin Islands

DME MAC - JC

A/B MAC - JN

HH + H MAC - J6

CGS Administrators, LLC

First Coast Service Options, Inc.

National Government Services, Inc.

Virginia

DME MAC - JC

A/B MAC - JL
(includes Part B for counties of Arlington and Fairfax, and the city of Alexandria)
A/B MAC - JM
(excludes Part B for the counties of Arlington and Fairfax, and the city of Alexandria)

HH + H MAC - J15

CGS Administrators, LLC

Novitas Solutions, Inc.

Palmetto GBA, LLC

CGS Administrators, LLC

Washington

DME MAC - JD

A/B MAC - JF

HH + H MAC - J6

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

National Government Services, Inc.

West Virginia

DME MAC - JC

A/B MAC - JM

HH + H MAC - J15

CGS Administrators, LLC

Palmetto GBA, LLC

CGS Administrators, LLC

Wisconsin

DME MAC - JB

A/B MAC - J6

HH + H MAC - J6

CGS Administrators, LLC

National Government Services, Inc.

National Government Services, Inc.

Wyoming

DME MAC - JD

A/B MAC - JF

HH + H MAC - J15

Noridian Healthcare Solutions, LLC

Noridian Healthcare Solutions, LLC

CGS Administrators, LLC

DME = Durable Medical Equipment
HH+H = Home Health and Hospice
A/B MAC = part A and part B Medicare Administrative Contractors

 

 

Page Last Modified:
10/15/2024 06:04 AM