Centers for Medicare & Medicaid Services

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Page Last Modified: 9/9/2008 8:43:46 PM

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Medicare Coverage Database

LCD Service Indication Report

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CMS Region I
CMS Region II
CMS Region III
CMS Region IV
CMS Region V
CMS Region VI
CMS Region VII
CMS Region VIII
CMS Region IX
CMS Region X

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Alabama
Alaska
American Samoa
Arizona
Arkansas
California - Entire State
California - Northern
California - Southern
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri - Entire State
Missouri - Northeastern & Southern
Missouri - Northwestern
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York - Entire State
New York - Downstate
New York - Queens
New York - Upstate
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming

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Carrier
DME MAC
DME PSC
DMERC
FI
MAC - Part A
MAC - Part B
RHHI

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AdminaStar Federal, Inc. (00635, DMERC)
Arkansas Blue Cross Blue Shield - Rhode Island (00021, FI)
Arkansas Blue Cross Blue Shield - Rhode Island (00524, Carrier)
Blue Cross and Blue Shield of Arizona (00030, FI)
Blue Cross and Blue Shield of Arkansas (00020, FI)
Blue Cross and Blue Shield of Arkansas (00520, Carrier)
Blue Cross and Blue Shield of Arkansas (00521, Carrier)
Blue Cross and Blue Shield of Arkansas (00522, Carrier)
Blue Cross and Blue Shield of Arkansas (00523, Carrier)
Blue Cross and Blue Shield of Arkansas (00528, Carrier)
Blue Cross and Blue Shield of Georgia (00101, FI)
Blue Cross and Blue Shield of Montana (00250, FI)
Blue Cross and Blue Shield of Montana (00751, Carrier)
Blue Cross and Blue Shield of Nebraska (00260, FI)
Blue Cross and Blue Shield of Rhode Island (00370, FI)
Blue Cross and Blue Shield of Rhode Island (00870, Carrier)
Blue Cross and Blue Shield of Wyoming (00460, FI)
BlueCross BlueShield of Tennessee (Riverbend Government Benefits Administrator) (00390, FI)
Cahaba Government Benefit Administrators,® LLC - Alabama (00010, FI)
Cahaba Government Benefit Administrators,® LLC - Midwest (00011, FI)
Cahaba Government Benefit Administrators,® LLC - Midwest (00011, RHHI)
Cahaba Government Benefit Administrators,® LLC - Midwest (00012, FI)
Cahaba Government Benefit Administrators®, LLC (00510, Carrier)
Cahaba Government Benefit Administrators®, LLC (00511, Carrier)
Cahaba Government Benefit Administrators®, LLC (00512, Carrier)
CareFirst Blue Cross and Blue Shield of Maryland (00190, FI)
Chisholm Administrative Services (00340, FI)
CIGNA Government Services (05130, Carrier)
CIGNA Government Services (05440, Carrier)
CIGNA Government Services (05535, Carrier)
CIGNA Government Services (05655, DMERC)
CIGNA Government Services (18003, DME MAC)
Cooperativa de Seguros de Vida de Puerto Rico (57400, FI)
Electronic Data Systems Corp. (77006, DME PSC)
First Coast Service Options, Inc. (00090, FI)
First Coast Service Options, Inc. (00590, Carrier)
First Coast Service Options, Inc. (00591, Carrier)
Group Health, Inc.(NY) (14330, Carrier)
HealthNow (00801, Carrier)
Highmark Medicare Services MD/Washington, DC Fiscal Intermediary (00366, FI)
Highmark Medicare Services Pennsylvania Carrier (00865, Carrier)
Highmark Medicare Services Pennsylvania Fiscal Intermediary (00363, FI)
Highmark Medicare Services, Inc. (12101, MAC - Part A)
Highmark Medicare Services, Inc. (12102, MAC - Part B)
Highmark Medicare Services, Inc. (12201, MAC - Part A)
Highmark Medicare Services, Inc. (12202, MAC - Part B)
Highmark Medicare Services, Inc. (12301, MAC - Part A)
Highmark Medicare Services, Inc. (12302, MAC - Part B)
Highmark Medicare Services, Inc. (12401, MAC - Part A)
Highmark Medicare Services, Inc. (12402, MAC - Part B)
Highmark Medicare Services, Inc. (12501, MAC - Part A)
Highmark Medicare Services, Inc. (12502, MAC - Part B)
Medicare Northwest (Regence of Blue Cross and Blue Shield of Oregon) (00350, FI)
Mutual of Omaha Insurance Company (52280, FI)
National Government Services, Inc. (00130, FI)
National Government Services, Inc. (00131, FI)
National Government Services, Inc. (00160, FI)
National Government Services, Inc. (00180, FI)
National Government Services, Inc. (00180, RHHI)
National Government Services, Inc. (00181, FI)
National Government Services, Inc. (00270, FI)
National Government Services, Inc. (00308, FI)
National Government Services, Inc. (00332, FI)
National Government Services, Inc. (00450, FI)
National Government Services, Inc. (00450, RHHI)
National Government Services, Inc. (00452, FI)
National Government Services, Inc. (00453, FI)
National Government Services, Inc. (00454, FI)
National Government Services, Inc. (00454, RHHI)
National Government Services, Inc. (00456, RHHI)
National Government Services, Inc. (00630, Carrier)
National Government Services, Inc. (00660, Carrier)
National Government Services, Inc. (00803, Carrier)
National Government Services, Inc. (00805, Carrier)
National Government Services, Inc. (13101, MAC - Part A)
National Government Services, Inc. (13102, MAC - Part B)
National Government Services, Inc. (13201, MAC - Part A)
National Government Services, Inc. (13202, MAC - Part B)
National Government Services, Inc. (13282, MAC - Part B)
National Government Services, Inc. (13292, MAC - Part B)
National Government Services, Inc. (17003, DME MAC)
NHIC (02101, MAC - Part A)
NHIC (02102, MAC - Part B)
NHIC (02201, MAC - Part A)
NHIC (02202, MAC - Part B)
NHIC (02301, MAC - Part A)
NHIC (02302, MAC - Part B)
NHIC (02401, MAC - Part A)
NHIC (02402, MAC - Part B)
NHIC (16003, DME MAC)
NHIC, Corp. (31140, Carrier)
NHIC, Corp. (31142, Carrier)
NHIC, Corp. (31143, Carrier)
NHIC, Corp. (31144, Carrier)
NHIC, Corp. (31145, Carrier)
NHIC, Corp. (31146, Carrier)
Noridian Administrative Services (00322, FI)
Noridian Administrative Services (00323, FI)
Noridian Administrative Services (00325, FI)
Noridian Administrative Services (00823, Carrier)
Noridian Administrative Services (03101, MAC - Part A)
Noridian Administrative Services (03102, MAC - Part B)
Noridian Administrative Services (03201, MAC - Part A)
Noridian Administrative Services (03202, MAC - Part B)
Noridian Administrative Services (03301, MAC - Part A)
Noridian Administrative Services (03302, MAC - Part B)
Noridian Administrative Services (03401, MAC - Part A)
Noridian Administrative Services (03402, MAC - Part B)
Noridian Administrative Services (03501, MAC - Part A)
Noridian Administrative Services (03502, MAC - Part B)
Noridian Administrative Services (03601, MAC - Part A)
Noridian Administrative Services (03602, MAC - Part B)
Noridian Administrative Services (19003, DME MAC)
Noridian Administrative Services, LLC (00320, FI)
Noridian Administrative Services, LLC (00820, Carrier)
Noridian Administrative Services, LLC (00821, Carrier)
Noridian Administrative Services, LLC (00824, Carrier)
Noridian Administrative Services, LLC (00825, Carrier)
Noridian Administrative Services, LLC (00826, Carrier)
Palmetto GBA (00380, FI)
Palmetto GBA (00380, RHHI)
Palmetto GBA (00382, FI)
Palmetto GBA (00880, Carrier)
Palmetto GBA (00883, Carrier)
Palmetto GBA (00884, Carrier)
Palmetto GBA (00885, DMERC)
Palmetto GBA (01101, MAC - Part A)
Palmetto GBA (01102, MAC - Part B)
Palmetto GBA (01192, MAC - Part B)
Palmetto GBA (01201, MAC - Part A)
Palmetto GBA (01202, MAC - Part B)
Palmetto GBA (01301, MAC - Part A)
Palmetto GBA (01302, MAC - Part B)
Premera Blue Cross (00430, FI)
Regence Blue Cross and Blue Shield of Utah (00910, Carrier)
TrailBlazer Health Enterprises, LLC (00400, FI)
TrailBlazer Health Enterprises, LLC (00900, Carrier)
TrailBlazer Health Enterprises, LLC (00901, Carrier)
TrailBlazer Health Enterprises, LLC (00902, Carrier)
TrailBlazer Health Enterprises, LLC (00903, Carrier)
TrailBlazer Health Enterprises, LLC (00904, Carrier)
TrailBlazer Health Enterprises, LLC (04101, MAC - Part A)
TrailBlazer Health Enterprises, LLC (04102, MAC - Part B)
TrailBlazer Health Enterprises, LLC (04201, MAC - Part A)
TrailBlazer Health Enterprises, LLC (04202, MAC - Part B)
TrailBlazer Health Enterprises, LLC (04301, MAC - Part A)
TrailBlazer Health Enterprises, LLC (04302, MAC - Part B)
TrailBlazer Health Enterprises, LLC (04401, MAC - Part A)
TrailBlazer Health Enterprises, LLC (04402, MAC - Part B)
TriCenturion (77011, DME PSC)
Tricenturion (77011, DMERC)
Triple-S, Inc. (00973, Carrier)
Triple-S, Inc. (00974, Carrier)
TriSpan Health Services (00230, FI)
TriSpan Health Services (00242, FI)
TrustSolutions (77012, DME PSC)
Wheatlands Administrative Services, Inc. (00150, FI)
Wheatlands Administrative Services, Inc. (00650, Carrier)
Wisconsin Physicians Service Insurance Corporation (00951, Carrier)
Wisconsin Physicians Service Insurance Corporation (00952, Carrier)
Wisconsin Physicians Service Insurance Corporation (00953, Carrier)
Wisconsin Physicians Service Insurance Corporation (00954, Carrier)
Wisconsin Physicians Service Insurance Corporation (05101, MAC - Part A)
Wisconsin Physicians Service Insurance Corporation (05102, MAC - Part B)
Wisconsin Physicians Service Insurance Corporation (05201, MAC - Part A)
Wisconsin Physicians Service Insurance Corporation (05202, MAC - Part B)
Wisconsin Physicians Service Insurance Corporation (05301, MAC - Part A)
Wisconsin Physicians Service Insurance Corporation (05302, MAC - Part B)
Wisconsin Physicians Service Insurance Corporation (05392, MAC - Part B)
Wisconsin Physicians Service Insurance Corporation (05401, MAC - Part A)
Wisconsin Physicians Service Insurance Corporation (05402, MAC - Part B)