--- title: "MAC, Medicare Administrative Contractor | MedTech Terms" description: "Private contractors that process Medicare Part A/B and DME claims and issue Local Coverage Determinations within their jurisdictions." lang: en json-ld: | { "@context": "https://schema.org", "@graph": [ { "@type": "DefinedTerm", "@id": "https://medtechterms.com/terms/mac#term", "name": "Medicare Administrative Contractor", "alternateName": "MAC", "description": "Medicare Administrative Contractors (MACs) are private companies CMS contracts with under the Medicare Modernization Act of 2003 to process Medicare fee-for-service claims, enroll providers, conduct medical review, and issue Local Coverage Determinations (LCDs). The country is divided into A/B MAC jurisdictions and four DME MAC jurisdictions. 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[Home](/) 2. / 3. [Terms](/terms) 4. / 5. [Reimbursement](/terms?cat=Reimbursement) 6. / 7. Medicare Administrative Contractor [All terms](/terms) Reimbursement [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer)MAC # Medicare Administrative Contractor Private contractors that process Medicare Part A/B and DME claims and issue Local Coverage Determinations within their jurisdictions. Reviewed by [Christian Espinosa, Founder, Blue Goat Cyber](/authors/christian-espinosa) Last reviewed May 9, 2026 ## Definition Medicare Administrative Contractors (MACs) are private companies CMS contracts with under the Medicare Modernization Act of 2003 to process Medicare fee-for-service claims, enroll providers, conduct medical review, and issue Local Coverage Determinations (LCDs). The country is divided into A/B MAC jurisdictions and four DME MAC jurisdictions. As of 2025 the principal A/B MACs include Noridian, Palmetto, Novitas, NGS, CGS, First Coast, and WPS. What the regulation says Statutory basis: Section 911 of the MMA, codified at 42 USC 1395kk-1. LCD process: Chapter 13 of the Medicare Program Integrity Manual. ## What this means in practice Because each MAC issues its own LCDs, the same device can be covered in one jurisdiction and not another, a structural reality MedTech market-access teams must plan around. MolDX (run by Palmetto) is the most influential MAC sub-program for [molecular diagnostics](/terms/molecular-diagnostics). Common pitfalls - • Assuming a national LCD where only jurisdictional LCDs exist. - • Engaging only one MAC when a multi-MAC strategy is needed for national coverage. ## Related terms Grouped by theme ### Editor's picks · Hand-selected related concepts [ Reimbursement LCD and NCD Local and National Coverage Determinations from Medicare. ](/terms/lcd-ncd)[ Reimbursement National and Local Coverage Determinations(NCD / LCD) Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). ](/terms/ncd-lcd)[ Reimbursement Durable Medical Equipment, Prosthetics, Orthotics, and Supplies(DMEPOS) Medicare benefit category covering durable medical equipment, prosthetics, orthotics, and supplies, billed under HCPCS Level II codes through DME MACs. ](/terms/dmepos) ### Reimbursement & Market Access · From this learning path [ Reimbursement New Technology Add-On Payment(NTAP) Supplemental Medicare payment for inpatient use of qualifying new technologies. Adjacent lesson ](/terms/ntap?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)[ Reimbursement Current Procedural Terminology Codes(CPT) AMA-maintained codes used to report medical procedures and services for billing. ](/terms/cpt?from=reimbursement-and-market-access) ### More in Reimbursement · Same category [ 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 7 of 14 Ecosystems (1) - [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer) ## Primary references 3 sources Link health: 3 verified · last checked 2026-06-20 CMS· 1 Cornell LII· 1 AdvaMed· 1 1. [1 CMS, Medicare Administrative Contractors Verified CMS · cms.gov ](https://www.cms.gov/medicare/coding-billing/medicare-administrative-contractors-macs) 2. [2 42 USC 1395kk-1, Medicare Administrative Contractors Verified Cornell LII · law.cornell.edu ](https://www.law.cornell.edu/uscode/text/42/1395kk-1) 3. [3 AdvaMed - Payment & Coverage Verified AdvaMed · advamed.org ](https://www.advamed.org/our-work/) 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 Acronym MAC Sources 3 Updated 5/9/2026 [Compare with another term](/compare?a=mac) Learn in 60 seconds Card Lesson Quiz Private contractors that process Medicare Part A/B and DME claims and issue Local Coverage Determinations within their jurisdictions. - · Because each MAC issues its own LCDs, the same device can be covered in one jurisdiction and not another, a structural reality MedTech market-access teams must plan around. - · MolDX (run by Palmetto) is the most influential MAC sub-program for molecular diagnostics. - · The country is divided into A/B MAC jurisdictions and four DME MAC jurisdictions. Remember this Watch out: Assuming a national LCD where only jurisdictional LCDs exist. Related terms - [LCD and NCD ](/terms/lcd-ncd) - [National and Local Coverage Determinations(NCD / LCD) ](/terms/ncd-lcd) - [Durable Medical Equipment, Prosthetics, Orthotics, and Supplies(DMEPOS) ](/terms/dmepos) You may also need Auto-suggested from Reimbursement and shared keywords. - [Recovery Audit Contractor(RAC) ](/terms/rac-audit) - [CMS IDE Coverage (Category A & B) ](/terms/ide-coverage) - [Coverage with Evidence Development(CED) ](/terms/ced) - [Initial Public Offering(IPO) ](/terms/ipo) - [NIST SP 800-53 / 800-171(NIST 800-53/171) ](/terms/nist-800-53) - [Transitional Coverage for Emerging Technologies(TCET) ](/terms/tcet) [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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