Definition
Last updated: Updated daily
CMS coverage policy updates are changes to Medicare's National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). These rules decide which services Medicare covers, when, and under what clinical circumstances. Billing teams who track them avoid downstream denials.
- NCDs apply nationally to all Medicare beneficiaries.
- LCDs are issued by Medicare Administrative Contractors (MACs) for specific regions.
- Coverage policy changes typically take effect 60 to 90 days after publication.
- This feed is refreshed daily from the CMS.gov Medicare Coverage Database.
LIVE FEED
What changed in Medicare coverage this month.
Live coverage policy updates from CMS.gov. National and Local Coverage Determinations. Refreshed daily.
Data from CMS.gov Medicare Coverage Database · Updated todayNATIONAL COVERAGE CHANGES
NCD updates
National Coverage Determinations apply to all Medicare beneficiaries.
| Doc ID | Title |
|---|---|
| 240.9 | Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure (CRF) Consequent to Chronic Obstructive Pulmonary Disease (COPD) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 220.6.17 | Positron Emission Tomography (FDG) for Oncologic Conditions Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 160.18 | Vagus Nerve Stimulation (VNS) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 90.2 | Next Generation Sequencing (NGS) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 110.18 | Aprepitant for Chemotherapy-Induced Emesis Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
LOCAL COVERAGE CHANGES
LCD updates
Local Coverage Determinations are issued by MACs for specific regions.
| Doc ID | Title |
|---|---|
| 240.9 | Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure (CRF) Consequent to Chronic Obstructive Pulmonary Disease (COPD) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 220.6.17 | Positron Emission Tomography (FDG) for Oncologic Conditions Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 160.18 | Vagus Nerve Stimulation (VNS) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 90.2 | Next Generation Sequencing (NGS) Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
| 110.18 | Aprepitant for Chemotherapy-Induced Emesis Updated NCD coding via a new Change Request/Transmittal, no policy changes. |
WHAT THIS MEANS FOR YOU
How to use this feed
Coverage policy changes typically precede denial waves by 30 to 60 days. Teams that track NCD and LCD updates catch the rule shift before claims start bouncing.
When you see a change to a code your practice bills, check three things: the effective date, the documentation requirements, and whether prior authorization rules shifted.
For a deeper view of payer behavior beyond Medicare, see the Payer Behavior Intelligence library.
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