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A National Coverage Determination (NCD) is a federal mandate of what Medicare covers. View the full NCD summary for each topic on the Centers for Medicare & Medicaid Services (CMS) website using the links below.

To view older NCDs, visit the CMS website Medicare Coverage Database and choose "National Coverage Documents" in the document type search.

Hyperbaric Oxygen (HBO) Therapy

April 3, 2017
The Centers for Medicare & Medicaid Services (CMS) received a reconsideration request to remove the coverage exclusion of Continuous Diffusion of Oxygen Therapy (CDO) from NCD Manual 20.29, Section C...
Decision Memo for Hyperbaric Oxygen (HBO) Therapy (Section C, Topical Oxygen) (CAG-00060R)

Leadless Pacemakers

January 18, 2017
After considering public comments, CMS will finalize its proposal to cover leadless pacemakers through Coverage with Evidence Development (CED). In addition to covering leadless pacemakers when procedures are performed in FDA approved studies, CMS will also cover...
Decision Memo for Leadless Pacemakers (CAG-00448N)

Percutaneous Image-guided Lumbar Decompression for Lumbar Spinal Stenosis

December 7, 2016
After considering public comments as required by section 1862(l) of the Social Security Act, CMS will finalize its proposal to continue CED and expand the January 2014 NCD. CMS will cover through a prospective longitudinal study PILD procedures using an FDA-approved/cleared device that...
Decision Memo for Percutaneous Image-guided Lumbar Decompression for Lumbar Spinal Stenosis (CAG-00433R)

Screening for Hepatitis B Virus Infection

September 28, 2016
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to conclude that screening for Hepatitis B Virus (HBV) infection, consistent with the grade A and B recommendations by the U.S. Preventive Services Task Force (USPSTF), is reasonable and necessary ...
Decision Memo for Screening for Hepatitis B Virus (HBV) Infection (CAG-00447N)

Gender Dysphoria and Gender Reassignment Surgery

August 30, 2016
Currently, the local Medicare Administrative Contractors (MACs) determine coverage of gender reassignment surgery on a case-by-case basis. We received a complete, formal request to make a national coverage determination on surgical remedies for gender identity disorder (GID), now known as gender dysphoria ...
Decision Memo for Gender Dysphoria and Gender Reassignment Surgery (CAG-00446N)

Percutaneous Left Atrial Appendage Closure Therapy

February 8, 2016
The Centers for Medicare & Medicaid Services (CMS) covers percutaneous left atrial appendage closure (LAAC) for non-valvular atrial fibrillation (NVAF) through Coverage with Evidence Development (CED) under 1862(a)(1)(E) of the Social Security Act with the following conditions ...
Percutaneous Left Atrial Appendage (LAA) Closure Therapy (CAG-00445N)

Stem Cell Transplantation

January 27, 2016
The Centers for Medicare & Medicaid Services (CMS) will modify our existing National Coverage Determinations Manual to expand national coverage for allogeneic hematopoietic stem cell transplantation (HSCT) for three separate medical conditions ...
Stem Cell Transplantation (Multiple Myeloma, Myelofibrosis, and Sickle Cell Disease) (CAG-00444R)

Positron Emission Tomography to Identify Bone Metastasis of Cancer

December 15, 2015
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary to diagnose or treat an illness or injury or to improve the functioning ...
Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2)

Screening for Cervical Cancer with Human Papillomavirus Testing

July 9, 2015
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to add Human Papillomavirus (HPV) testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test ...
Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing (CAG-00442N)

Screening for Colorectal Cancer

October 9, 2014
After considering public comments and consulting with appropriate organizations, the Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover CologuardTM – a multitarget stool DNA test ...
Screening for Colorectal Cancer - Stool DNA Testing (CAG-00440N)

Screening for the Human Immunodeficiency Virus

April 13, 2015
The Centers for Medicare & Medicaid Services (CMS) is expanding coverage in section 210.7 of the Medicare National Coverage Determinations (NCD) Manual.  CMS has determined that the evidence is adequate to conclude that screening for HIV infection for all individuals between the ages of 15 and 65 years ...
Screening for the Human Immunodeficiency Virus (HIV) Infection (CAG-00409R)

Microvolt T-wave Alternans

January 13, 2015
The Centers for Medicare & Medicaid Services has decided that no National Coverage Determination (NCD) is appropriate at this time for microvolt T-wave alternans (MTWA) testing using the modified moving average (MMA) method for the evaluation of patients at risk for sudden cardiac death (SCD) ...
Microvolt T-wave Alternans (CAG-00293R2)

Last updated 10/10/2017
Y0062_2018_MEDICARE Approved