Medicare local coverage
Medicare coverage for Facet Joint Interventions for Pain Management (LCD)
7 Medicare Administrative Contractors publish a local coverage determination (LCD) for Facet Joint Interventions for Pain Management. The snapshot lists 10 LCD records: 7 active, 2 with a future effective date, 1 retired.
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 |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L38773 | Active | Jul 17, 2026 |
First Coast Service Options, Inc.MAC - Part A, MAC - Part B | L33930 | Future, effective Dec 6, 2026 | Oct 16, 2026 |
First Coast Service Options, Inc.MAC - Part A, MAC - Part B | L33930 | Active | Aug 2, 2024 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38803 | Retired Apr 16, 2026 | Apr 16, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38801 | Active | Apr 6, 2026 |
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L34892 | Future, effective Dec 6, 2026 | Oct 16, 2026 |
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L34892 | Active | Aug 2, 2024 |
Palmetto GBAMAC - Part A, MAC - Part B | L38765 | Active | Apr 2, 2026 |
Wellpoint FederalMAC - Part A, MAC - Part B | L35936 | Active | Jul 16, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38841 | Active | May 21, 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.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A56670Novitas Solutions, Inc.Updated Apr 2, 2026
- A57787First Coast Service Options, Inc.Updated Apr 2, 2026
- A57826Wellpoint FederalUpdated Sep 15, 2026
- A58350Palmetto GBAUpdated Sep 11, 2026
- A58364CGS Administrators, LLCUpdated Sep 11, 2026
- A58403Noridian Healthcare Solutions, LLCUpdated Sep 9, 2026
- A58405Noridian Healthcare Solutions, LLCUpdated Apr 16, 2026
- A58477WPS Insurance CorporationUpdated Sep 9, 2026
CMS also lists 14 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58607, A58613, A58639, A58640, A58658, A59737, A59751, A59773, A59793, A59795, A59816, A59829, A60568, A60569.
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
- Epidural Steroid Injections for Pain Management
- Pain Management - Injection of tendon sheaths, ligaments, bursa, and ganglion cysts
- Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain
- Urinary Biomarkers for Chronic Pain Management
- Bariatric Surgical Management of Morbid Obesity
- Bowel Management Devices
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.