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    ReimbursementHospital Buyer & ReimbursementNCD / LCD

    National and Local Coverage Determinations

    Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD).

    Reviewed by Christian Espinosa, Founder, Blue Goat CyberLast reviewed May 5, 2026

    Definition

    An NCD is a binding nationwide Medicare coverage decision; an LCD is a coverage decision by a Medicare Administrative Contractor applicable in its jurisdiction. Both define when an item or service is reasonable and necessary.

    What this means in practice

    Many device coverage paths begin as LCDs that influence later national policy. Manufacturers engage MACs early on evidence requirements and coverage gaps.

    Cross-references

    Uses

    Concepts or artefacts this term builds on.

    Primary references

    3 sources
    Link health: 1 verified 2 needs review· last checked 2026-05-09
    CMS·2AdvaMed·1
    1. 1
      Medicare Coverage Database
      Needs review
      CMScms.gov
    2. 2
      AdvaMed - Payment & Coverage
      Verified
      AdvaMedadvamed.org
    3. 3
      CMS - Coverage
      Needs review
      CMScms.gov

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