The Centers for Medicare and Medicaid Services (CMS) establishes national coverage determination (NCDs) policies for items and services furnished through Medicare. CMS awards geographical jurisdictions to private health care insurers called Medicare Administrative Contractors (MACs), which develop Local Coverage Determination (LCD) policies and process claims.
NCDs supersede LCDs, but LCDs expand on coverage policies for each jurisdiction, and these coverage policies may vary, including information regarding appropriate coding, credentialing, diagnostic testing, and treatment. Medicare Part A and B providers are required to adhere to the LCDs that are in place for their particular jurisdiction. General information about Medicare coverage can be found in LCDs.
The AASM website offers a wealth of resources to members about Medicare, including information about:
- Medicare Jurisdictions
- Current NCDs and LCDs
- Medicare Administrative Contractor information
Learn more on the Medicare Policies page.