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).”

LCD Process Modernization Qs & As (PDF)
Medicare Program Integrity Manual, Chapter 13 - Local Coverage Determinations (PDF)
LCD What's New Report (Local Coverage Documents (LCDs) and Articles that were updated in the most recent Medicare Coverage Database (MCD) weekly update)

Upcoming meetings
Date	MAC/Jurisdiction	Location	Issues/Topics
October 9, 2023 JM 10:00 AM – 12:00 PM ET JJ 1:00 – 3:00 PM ET	Palmetto (JJ & JM)	Microsoft Teams Webinar	Homocysteine Level, Serum Surgical Treatment of Nails Trigger Point Injections (TPI)
October 11, 2023 2:00 – 4:00 PM CST	Noridian, JE/JF	Teleconference Only	MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy
October 12, 2023 1:00pm ET	Novitas JN	Webinar	Allergen Immunotherapy
October 13, 2023 10:00am ET	Novitas, JH/JL	Webinar	Allergen Immunotherapy
October 19, 2023 2:00 – 5:00 PM ET	HOST: NGS, J6 and JK -Palmetto GBA (JM & JJ) -Noridian (JE & JF) -WPS -CGS J15 -Novitas, JH & JL -First Coast	Teleconference Only	Botulinum Toxins
October 26, 2023 12:00‒2:00 p.m. CT; 1:00‒3:00 p.m. ET	NGS, J6/JK	Virtual by teleconference and webex	Trigger Point Injections (TPI) Pain Management - Injection of tendon sheaths, ligaments, ganglion cysts, carpal and tarsal tunnels Fluid Jet System Treatment for LUTS/BPH Implantable Continuous Glucose Monitors (I-CGM)
October 26th, 2023 5:00 PM – 7:00 PM CT	WPS J5 & J8	Webinar	MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules Bisphosphonate Drug Therapy Cataract Extraction Trigger Point Injections MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancer MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy MolDX: Molecular Testing for Solid Organ Allograft Rejection Lab: Special Histochemical Stains and Immunohistochemical Stains Implantable Continuous Glucose Monitors (I-CGM)

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

State	Jurisdiction (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

State

Jurisdiction (J)

Medicare Administrative Contractor (MAC)

Alabama

DME MAC - JC

A/B MAC - JJ

HH + H MAC - JM

Local Coverage Determinations

What is an LCD?

Medicare Administrative Contractors

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