Payer policies
Medicare coverage policies: NCDs, LCDs and manuals
Traditional Medicare coverage policy comes in two layers. National coverage determinations (NCDs) are written by CMS and apply everywhere. Local coverage determinations (LCDs) are written by the Medicare Administrative Contractors (MACs) and apply only in that contractor's jurisdiction, with a billing and coding article that lists the codes.
All of it is published in the CMS Medicare Coverage Database. The payment and claims rules that sit around coverage, from benefit definitions to claims processing, are in the CMS Internet-Only Manuals.
Where Medicare publishes its policies
Official Medicare pages, checked Oct 25, 2026. Policies change often; always read the version on the payer's site for your date of service.
Medicare Coverage Database search
Search NCDs, LCDs, billing and coding articles, proposed LCDs and national coverage analyses by keyword, code, contractor or state.
NCDNational Coverage NCD report
The CMS report of every national coverage determination, filterable by chapter and lab status.
LCDFinal LCDs, alphabetical report
The CMS report of final local coverage determinations, listed alphabetically.
LCDFinal LCDs by state
The same LCDs filtered to the state where the service is billed.
ManualsCMS Internet-Only Manuals (IOMs)
The program manuals, including 100-02 Benefit Policy, 100-03 National Coverage Determinations and 100-04 Claims Processing.
OverviewMedicare Coverage Center
CMS's starting point for how national coverage decisions are made and where to follow open ones.
Browse Medicare coverage policy
Medicare NCD list
All 345 national coverage determinations by manual section, with last-updated dates and CMS links.
Medicare LCD list by topic
475 local coverage topics, with every contractor that publishes each LCD side by side.
Medicare in RCIntel
RCIntel loads Medicare NCDs and LCDs from the CMS Coverage API. Coverage Check uses them to tell you, line by line, whether a claim's diagnoses support Medicare coverage for each procedure, with the policy and CMS source behind each answer. The same lookups are available over the API and MCP.
Ask a Medicare policy a question
Upload a Medicare policy to Payer Intelligence and ask it what you need to know. Every answer cites the section and page it came from.
Common questions
What is the difference between an NCD and an LCD?
An NCD is a national decision by CMS on whether Medicare covers an item or service, and every contractor must follow it. An LCD is written by one Medicare Administrative Contractor and applies only in its jurisdiction. Where an NCD exists, an LCD can add detail but cannot contradict it.
Where are the codes for an LCD?
In the billing and coding article that goes with the LCD. The article lists the CPT and HCPCS codes the policy applies to and the ICD-10 codes that support medical necessity. Each LCD topic page here links its articles.
How often does the Medicare Coverage Database change?
CMS says the downloadable MCD data is refreshed weekly, on Thursdays. Individual LCDs and articles change whenever a contractor publishes a revision, so check the version in effect for your date of service.