Medicare Reimbursement
The Centers for Medicare and Medicaid Services (CMS) provides the Medicare Coverage Database (MCD), which contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions. To determine what Medicare coverage determinations are in place, you should use the Quick Search or Advanced Search tool to find current policies in your geographic area/region. A LCD is a decision by a fiscal intermediary (FI) or carrier whether to cover a particular service on an intermediary-wide or carrier-wide basis (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.
Medicare Coverage Database
Search both the NCD and LCD databases using a variety of criteria such as keyword, diagnosis/procedure, and date.
Quick Search Advanced Search
Other Medicare Tools
- Medicare Contractor Directory (interactive map to determine Medicare carrier for a geographic area/region)
- Medicare Physician Fee Schedule (searchable database that provides payment information for services covered by the MPFS provided by physician and non-physician practitioners)
- ICD-10 Lookup Tool (the International Classification of Diseases, Tenth Edition is a clinical cataloging system being implemented in the U.S. healthcare industry.)
- MedPAC paymentBasics are simple guides from the Medicare Payment Advisory Commission about the Medicare payment system.
- National Provider Identifier Registry Public Search is a free directory of all active National Provider Identifier (NPI) records. Healthcare providers acquire their unique 10-digit NPIs to identify themselves in a standard way throughout their industry.