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The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local policy articles, and proposed NCD decisions. The database also includes several other types of national coverage policy related documents, including national coverage analyses (NCAs), coding analyses for labs (CALs), Medicare Evidence Development & Coverage Advisory Committee (MedCAC) proceedings, and Medicare coverage guidance documents.
The MCD includes a comment tool that the public can use to submit comments on National coverage documents open for public comment.
The MCD offers multiple ways to locate and view data:
- Search - Allows users to search both the NCD and LCD databases using a variety of criteria such as key word, coverage topic, and date.
- Indexes - Provides users with pre-defined lists of National and local coverage documents.
- Reports - Provides users with reports of National and local coverage data.
- Download - Allows users to download complete sets of LCDs and articles and the complete set of NCDs.
MCD vs. Medicare.gov - The MCD is intended for use by Medicare contractors, providers, and other healthcare industry professionals. People with Medicare, family members, and caregivers should visit Medicare.gov , the official U.S. Government site for people with Medicare, for the latest information on Medicare enrollment, benefits, and other helpful tools.
Frequency of MCD data updates - The National coverage information in this database is updated "real time," except the NCD download, which is updated weekly.
The local coverage information is updated on a weekly basis, usually on Thursdays.
The current database includes all National coverage information as of the current time, and all local coverage changes through 09/07/2008.
MCD Archive - Local coverage documents that have been retired for greater than 2 years (i.e., an Ending Date or Revision Ending Date older than 2 years) are stored in the MCD archive database. Please visit the MCD Archive Site to view them.
Information about LCDs and LCD Challenges - Section 522 of the Benefits Improvement and Protection Act (BIPA) defines an LCD as a decision by a fiscal intermediary (FI) or carrier whether to cover a particular service on an intermediary-wide or carrier-wide basis in accordance with Section 1862(a)(1)(A) of the Social Security Act (e.g., a determination as to whether the service or item is reasonable and necessary).
FIs, Carriers, Program Safeguard Contractors (PSC), and Medicare Administrative Contractors (MAC) are Medicare contractors that develop and/or adopt LCDs. Medicare contractors develop LCDs when there is no NCD or when there is a need to further define an NCD. The guidelines for LCD development are provided in Chapter 13 of the Medicare Program Integrity Manual.
Local policies consist of two separate, though usually closely related, documents: the LCD and the policy article. The LCD will contain only the reasonable and necessary language. Any non-reasonable and necessary language a Medicare contractor wishes to communicate to providers is done through the policy article. At the end of each LCD, there is a link to the related policy article and at the end of each policy article there is a link related to the LCD.
Page Last Modified: 9/9/2008 8:43:46 PM
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