What is the Medicare Coverage Database (MCD)?

The Medicare Coverage Database (MCD) is a searchable repository that has information related to what’s covered and not covered by Original Medicare. The MCD document types include National Coverage Determinations (NCDs), National Coverage Analyses (NCAs), Local Coverage Determinations (LCDs), Proposed LCDs, local coverage Articles, and Draft Articles.

The database also includes other types of National Coverage policy related documents, including Coding Analyses for Labs (CALs), Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) proceedings, Technical Assessments (TAs), and Medicare coverage guidance documents. Find more information on each of these document types on the Coverage Document Descriptions tile on the MCD Help & Resources page.

Why Would Someone Use the Coverage Database?

As a health care provider, you should understand Medicare coverage before providing services or items to Medicare patients. Because extensive coverage information is available, we expect health care providers to know Medicare coverage requirements to anticipate payment denial. If you don’t give the patient enough written advance notice that Medicare will likely deny the service or item, you’re financially liable.

However, if you give the patient proper written advance notice that we will likely deny payment for the service or item, and show this action on the claim, Medicare may hold the patient liable.

Medicare Contractors, providers, suppliers, and associated personnel use the MCD. Medicare patients, family members, and caregivers may visit Medicare.gov, the official U.S. Government site for people with Medicare, for the latest information on Medicare enrollment, benefits, and other helpful tools.

Below the MCD Search, find a list of resources called information cards. They include the Notice Board for key topics and site updates, a link to the Beneficiary Guide to help patients who may search the MCD for information, and the Public Comments card that lists National documents open for public comment. Access the comment submission form from this card.

Background: Medicare Coverage and Coverage Determinations

The Social Security Act (the Act) is the primary authority for all coverage provisions and subsequent policies. Medicare law limits coverage to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury, and within the scope of a Medicare benefit category. In certain cases, CMS develops an NCD for an item or service to be applied on a national basis for all people with Medicare meeting the criteria for coverage. Medicare Administrative Contractors (MACs) develop LCDs when no NCD exists or when they need to further define an NCD.

How Up to Date is the MCD?

CMS updates the national coverage information in the MCD in real time. For local coverage updates, CMS captures that information on Sunday night at midnight, and the MCD displays it on the following Thursday. We also update the national and local coverage download files weekly on Thursday. In addition, you should go to your MAC’s website and subscribe to their email list to know of new or changing LCDs.

How to Find the MCD

You can find the MCD on the MCD webpage on CMS.gov by choosing Medicare, then Coverage, and then Medicare Coverage Database.

Using the MCD

Start your search on the MCD webpage.

Click on the search bar and enter:

• keywords
• CPT
• HCPCS
• ICD-10-CM codes
• A document ID

The video below shows a search for the keyword cardiac. Note: The question mark icon in the upper right will pulse each time you land on the MCD page.

Top Navigation Bar

You can see the top navigation bar while you search and access each MCD page. Hover your cursor over an option, and you’ll see an underline appear under the option.

The video below shows the cursor hovering over each option, and an underline that appears underneath.

Throughout the database, the Back to Top arrow icon appears in the lower right corner of your page. Click it to quickly view the top of the MCD.

The Search option allows you to explore national and local coverage documents using criteria such as keyword, code, or document ID. You can learn more about search options in the Search section. The Reports tab in the top navigation bar includes a dropdown menu where you can select National Coverage and Local Coverage reports. You can learn more about accessing reports in the Reports section.

MCD Archive

You can find the Archive section by following the link to the Archive page next to the white gear icon for Settings. The MCD Archive allows you to find and read articles that are no longer in effect.

Basket

Save documents from your search using the Basket tool. After you complete your search, you can view the documents or email them.

The video below shows where to find the Basket tool and how to click it, and the documents you saved in the Basket.

Add to Basket Function

You can add items to the Basket from the list of search results.

The video below shows the option to select documents and add them to the Basket by clicking the Basket icon in the Basket icon column. Click the Basket button for each corresponding article to add the item to the Basket. The Contract Type now appears under the contractor name in the Contractor column, when Local Coverage documents appear in search results.

The Basket icon changes from grey to blue when you add a document to your Basket.

To view the items in your Basket, click the Basket icon in the navigation bar.

Email Basket Function

To email all the documents in your Basket, click the Email Basket button.

The video below shows how to use the Email Basket button to send items in the Basket to any email account.

Empty Basket Function

To empty the Basket, click the Trash Can icon at the top of the Empty Basket column to remove all contents.

The video below shows how to empty the Basket by clicking the Trash Can icon at the top of column to clear each item from the Basket.

To remove 1 or more documents, click the Trash Can icon in the document’s listing in your Basket.

The video below shows how to remove 1 item from the Basket by clicking the Trash Can icon in the row of the article you want to remove.

Once you click the Trash Can icon, you remove the document from the Basket.

The video below shows how to email the Basket contents and then click the Trash Can icon in the column to clear each article from the Basket.

MCD Document Types

The Medicare Coverage Database (MCD) is a searchable repository that has information related to what’s covered and not covered by Original Medicare. The documents in the database describe coverage at the national and local level. We list and describe document types briefly below. Find the Medicare Coverage Descriptions document on the Help & Resources page for more information on document types.

National Coverage Documents

National Coverage Determinations (NCDs) are national policy granting, limiting, or excluding Medicare coverage for a specific medical item or service.

Coding Analyses for Labs (CAL) is an abbreviated process, like the National Coverage Determination (NCD) process, for making changes to the coding component of the negotiated laboratory NCDs.

National Coverage Analysis (NCA) is a collection of documents that support the new review or a reconsideration of an NCD.

Medicare established the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) process to give independent guidance and expert advice to CMS on specific clinical topics. We use it to supplement our internal expertise and to ensure an unbiased and contemporary consideration of “state-of-the-art” technology and science.

A comprehensive Technology Assessment (TA) process supports each NCD and focuses on the quality of the evidence for a given technology.

CMS publishes Medicare Coverage Documents to help to relay coverage related information nationally.

Local Coverage Documents

A Local Coverage Determination (LCD) is a decision made by a Medicare Administrative Contractor (MAC) whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within the specific jurisdiction of the MAC.

Before an LCD becomes final, the MAC publishes Proposed LCDs, which include a public comment period. For Proposed LCDs approved to display on the MCD on January 1, 2022, or later, we display an LCD Tracking Sheet as a pop-up, overlaying the Proposed LCD, which it supports.

Local coverage Articles are a type of educational document published by the MACs. Articles often contain coding or other guidelines related to a LCD.

Draft articles are written in support of a Proposed LCD. Once Medicare releases the Proposed LCD as a final LCD, a Billing and Coding article replaces the draft article.

The Help Icon: Help & Resources

Find the Help & Resources page by clicking the question mark icon.

When you click the Help icon, in addition to the option of selecting the Help & Resources page, you can find a page-specific Page Help option, a Tour the Search option, a Tour the Reports option, and a Contact Us page.

You can follow along with the page tours by selecting either the Tour the Search or Tour the Reports options. If you have any questions, email us by selecting the Contact Us option.

The video below shows how to access the Help & Resources page by using the question mark icon in the upper right corner and selecting Help & Resources from the dropdown menu.

From there, you can find MCD data and archive information, including a How To Library, schedules, and other applications. Also, you can take a guided tour of the search feature by selecting Tour the Search.

The Settings Icon

The Settings icon, a white gear symbol to the right of the Help icon, gives you the choice to reset your search data. When you click it, the page explains that clicking OK resets the MCD search data, if the cache of search data didn’t refresh properly. The MCD should refresh automatically, but in case you would like to manually reset the cache, you can any time you choose.

The video below shows how to hover the cursor over each subject on the Help & Resources page and select the option you need.

On the Help & Resources page, the first tile option, Latest Site Updates, offers a full list of the newest features and updates you can find in the MCD. The other tiles include the Notice Board, the How To Library, MCD Data Schedule, the MCD Archive, Related Links, MCD vs Medicare.gov, and Local Coverage Info. The last tile option, the Coverage Document Descriptions, offers a handy guide that explains each type of document you can find in the MCD.

The MCD offers a Frequently Asked Questions (FAQ) modal. Access the feature by clicking on the Submit Feedback link on the bottom of every page or by selecting the Contact Us option in the Help icon of the navigation bar. Find answers to most of your questions there or submit feedback from the new modal.

Page Help

The MCD offers a Page Help option under the Help icon in the top right corner of each MCD webpage, inside the navigation bar. You can click the Page Help option for assistance about the current MCD page.

The video below shows how to find the Page Help option under the Help question mark icon.

The video below shows sample content found in the Page Help option for the MCD Search page.

The video below shows the Page Help page from the MCD Reports option.

Search

The Search option allows you to explore national and local coverage documents using criteria such as keyword, code, or document ID.

Use the MCD Search feature to find specific coverage documents or a document with certain keywords. We suggest searching by keyword, CPT code, HCPCS code, ICD-10 code, by document ID, or by MAC. See how you can use the Search feature in this section before we move on to understanding your search results.

Search Using the Hint List

Enter the document ID, keyword, code, or MAC name into the Search field. This list shows related articles, LCDs, and other potential matches.

As you use the Search feature, you may see the yellow AMA License Agreement bar. Select I Accept to continue your search

You may click to select and view any document from the Hint List, or you may narrow your search by selecting a state.

Then, you have the choice to narrow your search by selecting a state, but you can also use All States to return more results.

Launch your search by entering information and clicking the green submit button.

Search Results

The Search Results page shows a complete set of matches.

Searching by document ID is the most direct way to check if the document has any new changes. You can find the document ID at the beginning of an LCD, Article, or NCD.

When using a document ID search, the search works best when you use the entire ID, but you can use an incomplete ID or code. If you search for an incomplete document ID or code, this warning message appears. Note that MEDCAC, TA, and Medicare Coverage Documents can’t be searched for by document ID.

If you use the full document ID in your search, the Hint List will show hints or an exact match to view. Click the result to view it.

The Hint List also shows an option to search the entire database for the document ID, and an option to view current or retired articles.

To revise the search criteria, input new information into the Search field like a keyword or code. Click Search to leave the results page of the previous search and begin a new search. Learn more about searching by keyword or code in the Using the Search Results Filter Bar section of this product.

You can search by document ID for the following document types:

• LCDs have 6 characters, starting with the letter L: For example, L99999
• Proposed LCDs have 7 characters, starting with the letters DL: For example, DL99999
• Articles have 6 characters, starting with the letter A: For example, A99999
• NCDs are all numbers, with 2 or 3 segments separated by periods: For example: 99.9.9
• NCAs and CALs start with CAG-, then 6 or 7 characters: For example, CAG-00190R2

The figure above shows part of the search results.

Access the list of results by scrolling down to view each document.

1. Click on the document ID to view a NCD or LCD of interest. If a document has CPT or Current Dental Terminology (CDT) codes, you must accept the American Medical Association (AMA), American Dental Association (ADA), and National Uniform Billing Committee (NUBC) User Agreements before you can view the document. The AMA/ADA/NUBC User Agreement displays once per web session, the first time you view a document that may contain CPT or CDT codes. You must accept the agreement to view documents with CPT or CDT codes.
2. To add a document to your Basket, select the Basket icon in the right column next to the document. Then, click the Basket option in the navigation bar to view the items in your Basket.

The video below shows how to use the Basket icon to add items to your Basket.

The video below shows how the Basket option holds documents until you would like to read or print them. Click the Basket icon to see the items in your Basket.

Using the Search Results Filter Bar

Filter search results by accessing the filter buttons on the Filter Bar. Specifically filter through the results by selecting from the dropdown filter buttons, including Starts With, All Document Types, All States, All Contractors, and More.

The video below shows several ways to use the Filter Bar in the Search Results screen.

The viewing options in the Filter Bar offer a variety of ways to narrow the documents included in your search results, beyond searching by the document ID, code, or keyword. You can filter documents by their document type, by state, by contractor, or by 6 specific options listed under the More filter button.

The video below shows the Document Type filter in the Filter Bar of the Search Results page.

Start by selecting All Document Types to view the available options. You can select or deselect any listed option. Make sure to click Apply each time you change your selections.

The default setting is All Document Types, which includes all National Coverage and Local Coverage document types. As you change the filter and click Apply, the filter button label adapts to show your selection.

The video below shows how to deselect All Local Coverage to search for only National Coverage documents.

Deselecting the All Local Coverage column of options allows only the National Coverage Documents to appear, with the label All National Coverage then printed on the filter button. Again, the results are updated each time you change your selections and click Apply.

Selecting only NCDs, or any other singular category, under the All National Coverage option changes the label on the filter button to match your selection.

The video below shows the filter option being used to select only NCDs.

For example, if you only selected NCDs from the All National Coverage section, only those documents would appear, and the label of the filter button would change to read NCDs.

The dropdown list for the All States filter button offers a way to search each U.S. state and territory, including CMS Region 1 – CMS Region 10.

The video below shows the filter selection for All States.

You can search for a range of multiple states or regions by holding the Shift key as you select options.

The video below shows the filter option to select several specific states in a range.

The video below shows the filter options to select states or territories that aren’t part of an alphabetical range.

If you want to select specific states, territories, or regions at once, hold the Ctrl key as you select them. Like the other filter buttons, the label updates to match your selection. If you select more than 1 choice, Multiple States appears, but if you select 1 choice, that state, territory, or region name appears in the label. References to CMS Regions now appear with Arabic numerals instead of Roman numerals.

The video below shows how the label of the filter button adapts to your selection.

You can also filter your results by contractor by using the All Contractors filter button. The default setting returns all Local Coverage and National Coverage documents.

You can narrow your results by selecting specific contractors, and as you make those selections, new lists appear nearby. Filter your results by contractor number, contact type, or contractor name.

The video below shows the All Contractors filter when selecting options by Contractor Number.

The video below shows selecting Contract Type and how it changes the filter label and your search results.

Like the other filter buttons, the label changes names to match your selections.

The last filter button is More, which covers 6 categories: NCA/CAL Status (NCAs and CALs only); Benefit Category (NCAs, CALs, and NCDs only); CPT/HCPCS (Local Coverage only); ICD-10-CM (Local Coverage only); Date Criteria; and Article/LCD Status (Articles and LCDs only).

The video below shows the options available using the More button.

You can filter results for NCAs and CALs only by choosing between Open, Closed, or Open for Public Comment. Since NCA/CAL Status applies only to NCAs and CALS, the results will exclude all other document types.

The video below shows how the results change when filtering for NCA/CAL Status.

You can also view results by their Benefit Category, including NCAs, CALs, and NCDs only. Since the Benefit Category applies only to NCAs, CALS, and NCDs, the results will exclude all other document types.

The video below shows the Benefit Category option under the More button.

Filter Local Coverage results by using the CPT/HCPCS or ICD-10-CM code entry fields. Neither filter option returns National Coverage documents since those documents don’t include CPT/HCPCS codes or ICD-10-CM codes.

The video below shows how to use Code filters under the More button.

Enter the code in the appropriate Enter Code field. For ICD-10-CM codes, select Code Lookup to find the correct code.

The video below shows how to use the ICD-10-CM codes feature to narrow your results.

Filter for the most recent version of articles and LCDs by selecting Latest Update. The Search Results show articles and LCDs currently in effect, future effective, or retired. Since National Coverage documents don’t have versions, the Date Criteria filter doesn’t affect those results. You can also narrow your results by choosing only documents Currently in Effect or input a range of dates to apply to the results.

The video below shows how to use Date Criteria to narrow the results.

You can also sort the results in 5 ways, including Relevance, Title, Doc Type, Contractor, and Last Updated.

If you sort by Relevance, results appear in 2 sections. You can Jump To either Title Results or Entire Document Results.

The video below shows different options for viewing search results. In this example, there are options for Title Results or Entire Document Results.

Results that show the keyword in the title appear first, and results with the keyword in the body of the document appear second. For each list, the results appear alphabetically by title. As you change the Sort By option, the Jump To links change. Sorting by title lists each document alphabetically by its title. Sorting by document type lists articles, CALs, LCDs, and others alphabetically by title in each subcategory. Sorting by Contractor breaks up the documents into a National Coverage section and a Local Coverage Section.

The video below shows how to sort results by clicking Last Updated to show the results with most recent changes.

Using the Last Updated sort lists results in descending order by their most recent edit date. Results show the Last Updated date under the title for each document.

Keyword Searches

You can search by Keyword on the MCD Search page for National and Local Coverage documents that contain a specific word or words. Like we covered in the Using the Search Results Filter Bar section, you can filter any results by keywords that appear in the title or body of documents in your search results.

Reports

Select the Reports tab to view national and local coverage data, the What’s New Report in national coverage and local coverage, Annual Reports, NCA/CAL Reports, NCD Report, Medicare Coverage Documents Reports, or Other Coverage Reports, Final LCD Reports, Proposed LCD Reports, Article Reports, Self-Administered Drug (SAD) Exclusion List Report and Medicare Administrative Contractors (MAC) Contacts Reports.

The Reports tab in the top navigation bar includes a dropdown menu for National Coverage and Local Coverage reports. We added the new Med Cov Docs Open for Public Comment Report to the National Coverage list.

The video below shows how to use the dropdown box for a list of report options.

You can refine and customize the reports results available through the MCD by date and other criteria. The reports are excellent tools for finding NCDs, LCDs, and Articles that apply to your needs.

The video below shows how to access the MCD Reports page.

Using Reports

The Reports tab in the top navigation bar includes a dropdown menu that offers direct access to National Coverage and Local Coverage reports. Select an item in the dropdown menu or select the Reports tab to access the reports. The figure below displays the dropdown menu under the Reports tab in the top navigation bar.

The video below shows the dropdown menu for the Reports tab. The question mark icon in the upper right will pulse as the tab appears.

You can also access reports by clicking the Select a Report dropdown menu from the home screen of the MCD Reports page. Find reports using selection criteria.

The video below shows how to select a report from the MCD Reports Selection Criteria Page.

First, select a report from the list in the dropdown menu.

Select from the criteria to refine your results.

National Coverage Reports

What’s New Report

This report lists CALs, Medicare Coverage Documents (MCDs), MEDCAC meetings, NCAs, NCDs, and TAs posted in the last 7, 30, 60, 90, or 120 days, according to your specification. When you first select the report, a listing of all document types posted in the amount of time you choose will display. For documents posted in the last 7, 30, 60, or 90 days, change the criteria from the dropdown menu and re-run the report.

Annual Report

This report is a list of CALs, NCAs, or NCDs, or all 3, by year.

Other National Coverage Reports

View lists of National Coverage NCA/CAL Status Reports, NCA/CAL Open for Public Comment Report, NCD Report, MEDCAC Meetings Report, Technology Assessments Report, and Medicare Coverage Documents Report from the front MCD Reports page.

Local Coverage Reports

What’s New Report

Use this report to view the list of Local Coverage Documents that:

1. Have changed for a database update
2. Are new for a database update

Helpful Hint

Clicking on the MCD Help Icon from any of the Reports webpages provides instructions on how to custom design reports. You can also view a Tour of the Reports page.

Local Coverage Final LCDs Report

Access reports by Contractor, State or by Alphabetical list by selecting on the filter you need.

Local Coverage Proposed LCDs Reports

View proposed LCDs for all contractors by Alphabetical list, by Contractor, or by State. Currently, you can select a single contractor and 1 or more resulting Contract Numbers (not contractor types) in the Final LCDs by Contractor and Proposed LCDs by Contractor report results.

Local Coverage Articles Reports

View this report for a list of articles listed either Alphabetically, by Contractor, or by State.

Self-Administered Drug (SAD) Exclusion List Report

The report lists drugs determined by a contractor to be usually self-administered, and therefore, excluded from Medicare Part B coverage by law.

MAC Contacts Report

View contact information for Medicare Administrative Contractors (MACs). MACs process medical claims for Medicare and publish LCDs and Local Coverage Articles.

Downloads

You can download local and national coverage document data sets. Each download zip package contains a Read Me file, a data set, and an associated Data Dictionary. Older versions of LCDs and Articles may exist but aren’t included in the MCD and Downloads; see the MCD Archive button in the top navigation bar.

Using this feature, you can download local and national coverage document data sets. Each zip package contains a Read Me file, the data set, and a data dictionary.

The data dictionaries in the download files explain the content and use of each database.

Using the Downloads Tab

To access the Downloads feature, click Downloads in the top navigation bar. Accept the ADA/AMA/NUBC license agreements to proceed.

You can download the following data sets:

• Current LCDs
• Current and Retired LCDs
• Current Articles
• Current and Retired Articles
• NCDs

Select the data you would like to download and click either Download Data Dictionary or Download Data.

Data sets appear in a zipped format.

Note that most providers won’t use the download feature. Each download includes the data in a Microsoft Access (.mdb) file, as well as a comma separated value (.csv) file, so they may be imported into a user’s database management program.

MCD Downloads Information

Data Dictionary

Each data download includes a data dictionary that explains the content and structure of the database.

Attachments

LCDs, Articles, and NCDs may include supporting attachment documents, which aren’t included in the downloads. Attachments are only available from the Document view page of a Document on the MCD.

Retired LCDs and Articles

The downloads for LCDs and Articles offer a Retired documents option, for document versions that have been retired for less than a year. Retired LCDs and Articles move to the MCD Archive 1 year after their retirement dates.

Historical Versions

A document may have many published versions over time. The MCD Downloads only include the most recent version of each document. However, the most recent version includes the complete Revision History entries.

Resources

• Beneficiary Notices Initiative (BNI)
• CMS.gov Email Updates
• Medicare Coverage Center
• Medicare Coverage Database Notice Board
• Medicare Coverage General Information
• Medicare National Coverage Determinations (NCD) Manual
• Medicare Program Integrity Manual
• Official U.S. Government Site for Medicare

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