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CMS NCD Updates

Medicare coverage is limited to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). National coverage determinations (NCDs) are made through an evidence-based process, with opportunities for public participation. In some cases, CMS ’own research is supplemented by an outside technology assessment and/or consultation with the Medicare Evidence Development &Coverage Advisory Committee (MEDCAC) . In the absence of a national coverage policy, an item or service may be covered at the discretion of the Medicare contractors based on a local coverage determination (LCD).

  • NCD
  • Name
  • Description of update

  • 240.2
  • Home use of oxygen
  • Lowers initial period of coverage from 120 to 90 days

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=169 &ncdver=2 &bc=0


  • 210.14
  • Lung cancer screening with low exam dose computed tomography
  • Expands the eligibility criteria for this exam

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=364 &ncdver=2 &bc=0

 


  • 220.6.20
  • Beta Amyloid Positron Tomography in Dementia and Neurodegenerative Disease
  • Retired - no longer covered 

NCD - Beta Amyloid Positron Tomography in Dementia and Neurodegenerative Disease (RETIRED) (220.6.20) (cms.gov)


  • 280.16
  • · Seat Elevation Equipment (Power Operated) on Power Wheelchairs
  • · Included in Durable Medicare Equipment (DME)

NCD - Seat Elevation Equipment (Power Operated) on Power Wheelchairs (280.16) (cms.gov)


  • ·     CAG-00085R8
  • ·     Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting
  • ·       Approved for Medicare beneficiaries under the following condition
    • Patients with symptomatic carotid artery stenosis ≥50%; and
    • Patients with asymptomatic carotid artery stenosis ≥70%.

NCA - Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting (CAG-00085R8) - Decision Memo (cms.gov)

Last updated Apr 19, 2024