NATIONAL COVERAGE DETERMINATIONS

The Centers for Medicare & Medicaid Services (CMS) makes changes to the services covered by Medicare. These changes are updated via National Coverage Determinations (NCDs). Here, you can learn about CMS’s NCD process and view summaries of recent NCDs – each with the effective date listed and a link to the full NCD.

Effective 4/10/2018

The Centers for Medicare & Medicaid Services (CMS) has released a change request that informs contractors that effective for claims with dates of service …

Effective 3/16/2018

The Centers for Medicare & Medicaid Services (CMS) covers diagnostic laboratory tests using Next Generation Sequencing (NGS) when performed in a Clinical Laboratory …

Effective 2/15/2018

Effective for claims with dates of service on or after February 15, 2018, CMS advised that coverage of Implantable Cardiac Defibrillators (ICDs) is no longer contingent …

Effective 5/25/2017

Effective for services performed on or after May 25, 2017, The Centers for Medicare & Medicaid Services (CMS) will cover supervised exercise therapy (SET) for beneficiaries with intermittent claudication …

Effective 4/3/2017

The Centers for Medicare and Medicaid Services (CMS) has amended its previous National Coverage Determination (NCD) for HBO therapy by removing Section C from the NCD …

Effective 8/29/2017

The Centers for Medicare & Medicaid Services (CMS) has signaled its intent to cover leadless pacemakers through Coverage with Evidence Development (CED). Medicare covers leadless pacemakers …

Effective 12/7/2016

The Centers for Medicare & Medicaid Services (CMS) has determined that percutaneous image-guided lumbar decompression (PILD) for lumbar spinal stenosis (LSS) is not reasonable and necessary …

Effective 9/28/2016

Medicare will cover a screening test for hepatitis B (HBV) infection in nonpregnant adolescents and adults without symptoms of the infection who are determined by their primary …

Effective 8/30/2016

The Centers for Medicare & Medicaid Services (CMS) is not issuing a National Coverage Determination (NCD) at this time on gender reassignment surgery for Medicare beneficiaries with gender …

Effective 7/09/2015

Effective for services performed on or after 7/9/2015, Medicare will cover testing for Human Papillomavirus (HPV) once every 5 years for beneficiaries without symptoms …