Medicare local coverage
Medicare coverage for Drugs and Biologicals, Coverage of, for Label and Off-Label Uses (LCD)
One Medicare Administrative Contractor, Wellpoint Federal, publishes a local coverage determination (LCD) for Drugs and Biologicals, Coverage of, for Label and Off-Label Uses. The snapshot lists 1 LCD record: 1 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
Wellpoint FederalMAC - Part A, MAC - Part B | L33394 | Active | Jul 16, 2026 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
CMS also lists 3 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A59216, A59756, A59983.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Off-Label Use of Intravenous Immune Globulin (IVIG)
- Off-label Use of Rituximab and Rituximab Biosimilars
- Chemotherapy Drugs and their Adjuncts
- Controlled Substance Monitoring and Drugs of Abuse Testing
- Immunosuppressive Drugs
- Oral Anticancer Drugs
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.