tci Medicare Compliance & Reimbursement - 2024 Issue Q3

Reader Questions: Distinguish NCD From LCD

Question: What’s the difference between a national coverage determi­nation (NCD) and a local coverage determination (LCD), besides the obvious difference in scope? Nevada Subscriber Answer: One big difference between NCDs and LCDs is the way that they’re developed. According to the Centers for Medicare & Medicaid Services (CMS), LCDs are developed by Medicare Administrative Contractors (MACs), and NCDs are established by CMS. In a document about Medicare Coverage Type Descriptions, CMS says LCDs are decisions made by MACs “on whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within...

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