General Information Guide

National Coverage Determination

NCDs are policies developed by CMS that indicates whether and under what circumstances certain services are covered under the Medicare Program. NCDs are the same for all contractors across the country.

Medicare coverage is limited to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). NCDs are made through an evidence-based process, with opportunities for public participation. In some cases, CMS' own research is supplemented by an outside technology assessment and/or consultation with the MEDCAC. In the absence of a national coverage policy, an item or service may be covered at the discretion of the Medicare contractors based on an LCD.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 amended several portions of the NCD development process in which took place on 1/1/2004.

The CMS published a Federal Register notice, (78 FR 48164-69), updating the process used for opening, deciding or reconsidering NCDs under the Social Security Act (the Act). The notice further outlines an expedited administrative process, using specific criteria, to remove certain NCDs older than ten years since their most recent review, thereby enabling local Medicare contractors to determine coverage under the Act.

To request a reconsideration of NCDs, please refer to the NCD reconsideration process instructions found on the Medicare Coverage Database page.

Interested parties may submit national coverage requests and national coverage reconsideration requests electronically to NCDRequest@cms.hhs.gov or in writing to: 

Centers for Medicare & Medicaid Services
Director, Coverage and Analysis Group
7500 Security Blvd. (Mailstop C1-09-06)
Baltimore, MD 21244.

Visit How to Request an NCD for additional information.

Reviewed 10/21/2024