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

Biomarkers for Oncology

Bladder/Urothelial Tumor Markers

Laser Ablation of the Prostate

Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

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

Proton Beam Therapy
L35075, L36658, L33937

L34056, L33576

Urological Supplies

National Coverage Determinations

Incontinence Control Devices

Polymerase Chain Reaction PCR testing