What Is a National Coverage Determination (NCD)?

Before deciding whether Medicare should cover a particular item (such as a brace or a hearing aid) or a service (such as therapy or screenings), the federal government conducts a comprehensive review process, and occasionally Congress may pass a law requiring coverage of a particular item or service. After coverage determinations or decisions are authorized, Medicare coverage is modified and Medicare carriers and other contractors (including Medicare Advantage organizations) coordinate their processes to fulfill these new coverage obligations. The formal name for these decisions which allow, limit, or exclude Medicare coverage is known as a national coverage determination (NCD). Coverage guidelines and effective dates are defined by Medicare or other rule making authority.

Below are changes that have been announced within the past year. It will be updated periodically. For more information, please contact Customer Service at 541-768-4550 or toll free 800-832-4580 (TTY 800-735-2900). Customer Service is available:

  • Oct. 1 to March 31: Daily, from 8 a.m. to 8 p.m.
  • April 1 to Sept. 30: Monday through Friday, from 8 a.m. to 8 p.m.

NCD Changes

2023 NCD Changes 

2022 NCD Changes 

2021 NCD Changes 

For more details, see the links below on the CMS Website.

2020 NCD Changes

See details on the CMS website. What’s new: The purpose of this change request is to inform MACs that CMS will cover acupuncture for chronic low back pain (cLBP) effective for claims with dates of service on and after Jan. 21, 2020.

Page Updated 6-7-2023

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