--- title: "LCD and NCD, Definition | MedTech Terms" description: "Local and National Coverage Determinations from Medicare. Plain-English Reimbursement definition for MedTech teams, with examples and related terms." lang: en json-ld: | { "@context": "https://schema.org", "@graph": [ { "@type": "DefinedTerm", "@id": "https://medtechterms.com/terms/lcd-ncd#term", "name": "LCD and NCD", "description": "A National Coverage Determination (NCD) is a Medicare-wide policy on whether and under what conditions an item or service is covered. 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[Reimbursement](/terms?cat=Reimbursement) 6. / 7. LCD and NCD [All terms](/terms) Reimbursement [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer) # LCD and NCD Local and National Coverage Determinations from Medicare. Reviewed by [Christian Espinosa, Founder, Blue Goat Cyber](/authors/christian-espinosa) Last reviewed May 5, 2026 ## Definition A National Coverage Determination (NCD) is a Medicare-wide policy on whether and under what conditions an item or service is covered. A Local Coverage Determination (LCD) is issued by a [Medicare Administrative Contractor](/terms/mac) (MAC) for its jurisdiction. What the regulation says The Centers for Medicare & Medicaid Services (CMS) establishes National Coverage Determinations (NCDs) to specify the conditions under which a particular medical item or service is covered nationally under Medicare. Local Coverage Determinations (LCDs) are developed by Medicare Administrative Contractors (MACs) to define coverage within their specific geographic jurisdictions, often preceding or complementing NCDs. ## What this means in practice Coverage typically begins as LCD policy via one or more MACs; pivotal NCDs (e.g., TAVR, TCAR, TMVR) define the national clinical-evidence and facility/operator standards. ## Examples - A MedTech manufacturer developing a new diagnostic imaging device must review existing NCDs and relevant LCDs to understand the evidence required for Medicare coverage and reimbursement. - A quality assurance team ensures that product labeling and marketing materials accurately reflect the limitations and conditions of coverage specified in applicable NCDs and LCDs. - During clinical trial design, a regulatory professional considers the data requirements outlined in potential NCDs or LCDs to ensure the study generates sufficient evidence for future reimbursement. Common pitfalls - • Misinterpreting an LCD as a national policy can lead to denied claims in other jurisdictions. - • Failing to consider both NCDs and relevant LCDs when determining coverage for a medical device or service can result in incomplete reimbursement strategies. - • Assuming that an absence of an NCD means automatic coverage can lead to significant financial losses if an LCD also denies coverage. - • Not understanding the specific evidence requirements outlined in an NCD or LCD can lead to insufficient clinical trial design or data collection activities. ## Frequently asked questions How do NCDs and LCDs impact MedTech manufacturers? NCDs and LCDs directly influence market access and reimbursement for MedTech products. Manufacturers must understand these policies to ensure their devices meet coverage criteria and are eligible for payment by Medicare. Can an LCD contradict an NCD? Where can I find NCDs and LCDs? ## Related terms Grouped by theme ### Editor's picks · Hand-selected related concepts [ Reimbursement New Technology Add-On Payment(NTAP) Supplemental Medicare payment for inpatient use of qualifying new technologies. ](/terms/ntap)[ Market Segments Molecular Diagnostics IVDs that detect nucleic acids - DNA or RNA - to diagnose disease. ](/terms/molecular-diagnostics) ### Reimbursement & Market Access · From this learning path [ Reimbursement Medicare Administrative Contractor(MAC) Private contractors that process Medicare Part A/B and DME claims and issue Local Coverage Determinations within their jurisdictions. Adjacent lesson ](/terms/mac?from=reimbursement-and-market-access)[ Reimbursement National and Local Coverage Determinations(NCD / LCD) Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). Adjacent lesson ](/terms/ncd-lcd?from=reimbursement-and-market-access)[ Reimbursement Budget Impact Model(BIM) Financial model that estimates the total cost consequences of adopting a new technology to a payer's budget over a defined horizon. ](/terms/budget-impact-model?from=reimbursement-and-market-access)[ Reimbursement CPT Codes(CPT) AMA-maintained codes that describe medical procedures and services. ](/terms/cpt-codes?from=reimbursement-and-market-access) ### More in Reimbursement · Same category [ Reimbursement Current Procedural Terminology Codes(CPT) AMA-maintained codes used to report medical procedures and services for billing. ](/terms/cpt)[ Reimbursement HCPCS Codes(HCPCS) CMS-maintained codes for products, supplies, and services not in CPT. ](/terms/hcpcs) Cited by Where this term appears across MedTech Terms. Learning paths (1) - [Reimbursement & Market Access](/paths/reimbursement-and-market-access)Lesson 6 of 14 Ecosystems (1) - [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer) ## Primary references 2 sources Link health: 2 verified · last checked 2026-06-20 AdvaMed· 1 AMA· 1 1. [1 AdvaMed - Payment & Coverage Verified AdvaMed · advamed.org ](https://www.advamed.org/our-work/) 2. [2 AMA CPT Resources Verified AMA · ama-assn.org ](https://www.ama-assn.org/practice-management/cpt) Inline markers like \[1\] jump to the matching reference above. Sponsor note ### Need cybersecurity expertise on a connected-device launch? Blue Goat Cyber helps MedTech teams ship connected products that hospital security teams will actually procure. [Book a 30-minute discovery session](https://go.bluegoatcyber.com/meetings/blue-goat-cyber/discovery-session) - No obligation - Expert-led from minute one - NDA available on request MedTech Terms is a community resource sponsored by [Blue Goat Cyber](https://bluegoatcyber.com). Definitions are independent of any vendor. On this term Category Reimbursement Sources 2 Updated 5/5/2026 [Compare with another term](/compare?a=lcd-ncd) Learn in 60 seconds Card Lesson Quiz Local and National Coverage Determinations from Medicare. - · Coverage typically begins as LCD policy via one or more MACs; pivotal NCDs (e.g., TAVR, TCAR, TMVR) define the national clinical-evidence and facility/operator standards. - · A Local Coverage Determination (LCD) is issued by a Medicare Administrative Contractor (MAC) for its jurisdiction. Remember this Watch out: Misinterpreting an LCD as a national policy can lead to denied claims in other jurisdictions. Related terms - [New Technology Add-On Payment(NTAP) ](/terms/ntap) - [Molecular Diagnostics ](/terms/molecular-diagnostics) You may also need Auto-suggested from Reimbursement and shared keywords. - [National and Local Coverage Determinations(NCD / LCD) ](/terms/ncd-lcd) - [Medicare Administrative Contractor(MAC) ](/terms/mac) - [CMS IDE Coverage (Category A & B) ](/terms/ide-coverage) - [Transitional Coverage for Emerging Technologies(TCET) ](/terms/tcet) - [Ambulatory Payment Classification(APC) ](/terms/apc) - [Site-Neutral Payment ](/terms/site-neutral-payment) [All Reimbursement terms](/terms?cat=Reimbursement) MedTech Terms An authoritative, plain-language reference for the regulatory, quality, cybersecurity, and software terms that shape modern medical devices. 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