Welcome to the Medicare Coverage Database
The Medicare Coverage Database (MCD) contains all National Coverage Determinations
(NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed
NCD decisions. The database also includes several other types of National Coverage
policy related documents, including National Coverage Analyses (NCAs), Coding Analyses
for Labs (CALs), Medicare Evidence Development & Coverage Advisory Committee
(MEDCAC) proceedings, and Medicare coverage guidance documents.
How to Use this Site
The MCD offers multiple ways to locate and view data:
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QUICK SEARCH - Allows users to search both the NCD and LCD databases using a variety of criteria such as keyword, diagnosis/procedure, and date. You can use the Quick search to your right. Or click on
ADVANCED SEARCH
to use additional filters to find exactly what you are looking for.
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INDEXES
- Provides users with pre-defined lists of National and Local Coverage documents.
-
REPORTS
- Provides users with reports of National and Local Coverage data.
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DOWNLOADS
- Allows users to download complete sets of LCDs and articles and the complete set
of NCDs.
- Contextual Help & Page Help
- Contextual Help is a new feature that provides users with the ability to receive onscreen help
for specific elements on the page. To use the feature, click the "Contextual Help" link and move the
mouse to the onscreen location of the associated page element. The user can turn the feature off when help
is no longer required. Users who are unable to use this feature, or who prefer to have a link to a single page
of help for the entire page, may continue to use the "Page Help" link to get assistance.
- Click on the corresponding link at the
top of the page to get started.
MCD vs. Medicare.gov
The MCD is intended for use by Medicare contractors, providers, and other healthcare
industry professionals. People with Medicare, family members, and caregivers should
visit
Medicare.gov opens in new window
, the official U.S. Government site for people with Medicare, for the latest information
on Medicare enrollment, benefits, and other helpful tools.
Information about LCDs and LCD Challenges
Section 522 of the Benefits Improvement and Protection Act (BIPA) defines an LCD as a decision by a fiscal intermediary (FI) or carrier whether to cover a particular service on an intermediary-wide or carrier-wide basis in accordance with Section 1862(a)(1)(A) of the Social Security Act (e.g., a determination as to whether the service or item is reasonable and necessary).
FIs, Carriers, and Medicare Administrative Contractors (MACs) are Medicare contractors that develop and/or adopt LCDs. Medicare contractors develop LCDs when there is no National Coverage Determination (NCD) or when there is a need to further define an NCD. The guidelines for LCD development are provided in Chapter 13 of the Medicare Program Integrity Manual.
A local policy may consist of two separate, though closely related documents: the LCD and an associated article. The LCD only contains reasonable and necessary language. Any non-reasonable and necessary language a Medicare contractor wishes to communicate to providers may be done through the article. At the end of an LCD that has an associated article, there is a link to the related article and vice versa.