--- title: "NCD / LCD Definition & Meaning | MedTech Terms" description: "Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). Plain-English Reimbursement definition for MedTech teams, with exampl" lang: en json-ld: | { "@context": "https://schema.org", "@graph": [ { "@type": "DefinedTerm", "@id": "https://medtechterms.com/terms/ncd-lcd#term", "name": "National and Local Coverage Determinations", "alternateName": "NCD / LCD", "description": "An NCD is a binding nationwide Medicare coverage decision; an LCD is a coverage decision by a Medicare Administrative Contractor applicable in its jurisdiction. 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[Home](/) 2. / 3. [Terms](/terms) 4. / 5. [Reimbursement](/terms?cat=Reimbursement) 6. / 7. National and Local Coverage Determinations [All terms](/terms) Reimbursement [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer)NCD / 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 Cyber](/authors/christian-espinosa) Last 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](/terms/mac) applicable in its jurisdiction. Both define when an item or service is reasonable and necessary. What the regulation says The Centers for Medicare & Medicaid Services (CMS) issues National Coverage Determinations (NCDs) as national policy, binding for all Medicare contractors and providers. Medicare Administrative Contractors (MACs) issue Local Coverage Determinations (LCDs) within their specific jurisdictions. These determinations clarify when an item or service is considered "reasonable and necessary" under the Medicare Act, often influencing product development and market access strategies for MedTech companies. ## 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. ## Examples - A manufacturer of a novel cardiac diagnostic device conducts a multi-center clinical trial to generate evidence supporting its clinical utility, aiming for an LCD with a regional MAC. - A company developing an AI-powered diagnostic software seeks to understand existing NCDs related to imaging services to align their product - s intended use and evidence generation strategy. Common pitfalls - • A common pitfall is failing to engage with MACs early in the product development lifecycle to understand evidence requirements for LCDs. - • Another mistake is assuming that an LCD in one jurisdiction will automatically translate to an NCD or coverage in other MAC jurisdictions. - • Companies sometimes underestimate the significant financial and time investment required to generate the clinical evidence needed to support NCD or LCD approval. - • Ignoring the nuances of "reasonable and necessary" criteria, which can vary between NCDs and LCDs, can lead to unfavorable coverage decisions. - • A pitfall is neglecting to monitor updates and revisions to NCDs and LCDs, which can impact existing coverage for MedTech products. ## Frequently asked questions How do NCDs and LCDs impact MedTech product market entry? NCDs and LCDs directly influence whether a new MedTech product will be reimbursed by Medicare, which is critical for market adoption and financial viability. Without a favorable coverage decision, market entry can be significantly hindered. Can an LCD become an NCD? What kind of evidence is typically required for NCDs and LCDs? ## Cross-references ### Uses Concepts or artefacts this term builds on. - [ Coverage with Evidence Development(CED) ](/terms/ced) ## Related terms Grouped by theme ### Editor's picks · Hand-selected related concepts [ Reimbursement Current Procedural Terminology Codes(CPT) AMA-maintained codes used to report medical procedures and services for billing. ](/terms/cpt)[ Reimbursement Coverage with Evidence Development(CED) Medicare paradigm conditioning coverage on participation in approved clinical studies or registries. ](/terms/ced) ### Reimbursement & Market Access · From this learning path [ Reimbursement ICD-10-CM / ICD-10-PCS Diagnosis (CM) and inpatient procedure (PCS) coding systems used in U.S. claims. Adjacent lesson ](/terms/icd-10?from=reimbursement-and-market-access)[ Reimbursement LCD and NCD Local and National Coverage Determinations from Medicare. Adjacent lesson ](/terms/lcd-ncd?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 HCPCS Codes(HCPCS) CMS-maintained codes for products, supplies, and services not in CPT. ](/terms/hcpcs)[ Reimbursement Health Technology Assessment(HTA) Systematic evaluation of clinical and economic value of a health technology. ](/terms/hta) Cited by Where this term appears across MedTech Terms. Learning paths (1) - [Reimbursement & Market Access](/paths/reimbursement-and-market-access)Lesson 5 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 Acronym NCD / LCD Sources 2 Updated 5/5/2026 [Compare with another term](/compare?a=ncd-lcd) Learn in 60 seconds Card Lesson Quiz Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). - · Many device coverage paths begin as LCDs that influence later national policy. - · Manufacturers engage MACs early on evidence requirements and coverage gaps. - · Both define when an item or service is reasonable and necessary. Remember this Watch out: A common pitfall is failing to engage with MACs early in the product development lifecycle to understand evidence requirements for LCDs. Related terms - [Current Procedural Terminology Codes(CPT) ](/terms/cpt) - [Coverage with Evidence Development(CED) ](/terms/ced) You may also need Auto-suggested from Reimbursement and shared keywords. - [LCD and NCD ](/terms/lcd-ncd) - [Medicare Administrative Contractor(MAC) ](/terms/mac) - [Transitional Coverage for Emerging Technologies(TCET) ](/terms/tcet) - [Durable Medical Equipment, Prosthetics, Orthotics, and Supplies(DMEPOS) ](/terms/dmepos) - [Recovery Audit Contractor(RAC) ](/terms/rac-audit) - [Ambulatory Payment Classification(APC) ](/terms/apc) [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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