Local Coverage Determinations

Local Coverage Determinations | CMS [Skip to main content](#skipNavTarget) ** [](https://www.cms.gov/) Centers for Medicare & Medicaid Services ## [CMS Newsroom](https://www.cms.gov/about-cms/contact/newsroom) ## Search CMS.gov SearchSearch** Popular terms * Physician Fee Schedule** * Local Coverage Determination** * Medically Unlikely Edits** * Telehealth** * Covid-19** * Agents and Brokers** ** ** # 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)](https://www.cms.gov/medicare/coverage/determinationprocess/downloads/lcd_qsas.pdf) * [Medicare Program Integrity Manual, Chapter 13 - Local Coverage Determinations (PDF)](https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/pim83c13.pdf) * [LCD What's New Report](https://www.cms.gov/medicare-coverage-database/reports/local-coverage-whats-new-report.aspx?bc=AQAAAAAAAAAA&)(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| [February 3, 2025 (PDF)](https://www.cms.gov/files/document/meeting-information.pdf) 2:00 –4:00 PM ET|Multijurisdictional Contractor Advisory Committee Meeting Host: Palmetto GBA|Webinar|Peripheral Nerve Blocks| *Click the date for more information on each meeting* ## Medicare Administrative Contractors [A](#A)/[C](#C)/[D](#D)/[F](#F)/[G](#G)/[H](#H)/[I](#I)/[K](#K)/[L](#L)/[M](#M)/[N](#N)/[O](#O)/[P](#P)/[R](#R)/[S](#S)/[T](#T)/[U](#U)/[V](#V)/[W](#W) |State|Jurisdiction (J)|Medicare Administrative Contractor (MAC)| Alabama| DME MAC - JC A/B MAC - JJ HH + H MAC - JM | [CGS Administrators, LLC](https://www.cgsmedicare.com/) [Palmetto GBA, LLC](https://www.palmettogba.com/) [Palmetto GBA, LLC](https://www.palmettogba.com/) | Alaska| DME MAC - JD A/B MAC - JF HH+ H MAC - J6 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [National Government Services, Inc.](https://www.ngsmedicare.com) | American Samoa| DME MAC - JD A/B MAC - JE HH + H MAC - J6 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [National Government Services, Inc.](https://www.ngsmedicare.com) | Arizona| DME MAC - JD A/B MAC - JF HH + H MAC - J6 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [National Government Services, Inc.](https://www.ngsmedicare.com) | Arkansas| DME MAC - JC A/B MAC - JH HH + H MAC - JM | [CGS Administrators, LLC](https://www.cgsmedicare.com/) [Novitas Solutions, Inc.](https://www.novitas-solutions.com/webcenter/portal/NovitasSolutions) [Palmetto GBA, LLC](https://www.palmettogba.com/) | California| DME MAC - JD A/B MAC - JE HH + H MAC - J6 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [National Government Services, Inc.](https://www.ngsmedicare.com) | Colorado| DME MAC - JC A/B MAC - JH HH + H MAC - J15 | [CGS Administrators, LLC](https://www.cgsmedicare.com/) [Novitas Solutions, Inc.](https://www.novitas-solutions.com/webcenter/portal/NovitasSolutions) [CGS Administrators, LLC](https://www.cgsmedicare.com/) | Connecticut| DME MAC - JA A/B MAC - JK HH + H MAC - JK | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [National Government Services, Inc.](https://www.ngsmedicare.com) [National Government Services, Inc.](https://www.ngsmedicare.com) | Delaware| DME MAC - JA A/B MAC - JL HH + H MAC - J15 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Novitas Solutions, Inc.](https://www.novitas-solutions.com/webcenter/portal/NovitasSolutions) [CGS Administrators, LLC](https://www.cgsmedicare.com/) | District of Columbia| DME MAC - JA A/B MAC - JL HH + H MAC - J15 | [Noridian Healthcare Solutions, LLC](https://med.noridianmedicare.com/) [Novitas Solutions, Inc.](https://www.novitas-solutions.com/webcenter/portal/NovitasSolutions) [CGS Administrators, LLC](https://www.cgsmedicare.com/) | Florida| DME MAC - JC A/B MAC - JN HH + H MAC - JM | [CGS Administrators, LLC](https://www.cgsmedicare.com/) [First Coast Service Options, Inc.](https://www.fcso.com/) [Palmetto GBA, LLC](https://www.palmett

Covered for patients who are homebound and require skilled nursing care or therapy services. Medically necessary when a physician certifies the need for care and develops a plan of treatment.

Not covered for services that are primarily custodial in nature. Will not cover if patient is not homebound or does not require skilled nursing.

Physician's plan of care must be documented. Clinical notes must show the need for skilled services.