Medicare local coverage
Medicare coverage for Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease (LCD)
5 Medicare Administrative Contractors publish a local coverage determination (LCD) for Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease. The snapshot lists 6 LCD records: 5 active, 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 | L38771 | Active | Aug 28, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38615 | Retired Mar 5, 2026 | Mar 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38613 | Active | Feb 23, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L38278 | Active | Jun 11, 2025 |
Wellpoint FederalMAC - Part A, MAC - Part B | L39075 | Active | Jul 14, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38839 | 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.
- A58095Noridian Healthcare Solutions, LLCUpdated Sep 22, 2026
- A58097Noridian Healthcare Solutions, LLCUpdated Mar 5, 2026
- A58359CGS Administrators, LLCUpdated Aug 28, 2026
- A58406Palmetto GBAUpdated Jan 20, 2026
- A58473WPS Insurance CorporationUpdated Apr 30, 2026
- A58814Wellpoint FederalUpdated Aug 13, 2026
CMS also lists 5 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A59132, A59211, A59212, A59327, A60200.
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
- Non-Invasive Abdominal / Visceral Vascular Studies
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
- Non-Invasive Cerebrovascular Arterial Studies
- Non-Invasive Cerebrovascular Studies
- Non-invasive Extracranial Arterial Studies
- Non-Invasive Peripheral Arterial Vascular Studies
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.