Medicare’s Local and National Coverage Determinations Guide
Medical coverage under Medicaid is determined by the Centers for Medicaid and Medicare Services through the regulatory process and outlined in documents known as local coverage determinations (LCDS) and national coverage determinations (NCDS).
Most urological services are covered under local coverage determinations, decisions made by a Medicare Administrative Contractor (MAC) on covering a particular item or service in a MAC's jurisdiction (region).
We have collected links to many of the LCDs affecting urological services below; this piece will be updated to keep the links up to date with the latest versions of the coverage determinations.
For current coverage on new and modified Medicare coverage determinations, you can view Medicare’s What’s New Report at the following links:
LCD What's New Report
NCD What’s New Report
Local Coverage Determinations
Biomarker Testing for Prostate Cancer Diagnosis L37733 Biomarkers for Oncology L35396 Bladder/Urothelial Tumor Markers L36975 Independent Diagnostic Testing Facilities- physician supervision and technician requirements A54953 Laser Ablation of the Prostate L34090 Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer L38966 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer L38997, L39005, L39007, L38985, L39042 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing L39038, L39001, L39003, L38988, L39044 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease L38303, L38339, L38341, L38292, L38433 Prostate Cancer Detection with IsoPSA L39284 Proton Beam Therapy L35075, L36658, L33937 Urodynamics L34056, L33576 Urological Supplies L33803 National Coverage Determinations Incontinence Control Devices 230.10
Polymerase Chain Reaction PCR testing
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