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The Centers for Medicare and Medicaid Services (CMS) Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions. The database also includes several other types of National Coverage policy related documents, including National Coverage Analyses (NCAs), Coding Analyses for Labs (CALs), Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) proceedings, Technical Assessments (TAs), and Medicare coverage guidance documents.

The MCD is located at https://www.cms.gov/medicare-coverage-database , one of the top links on the CMS website homepage.​​​​​​​​​

  
  
  
  
  
  
  
  
  
  
MPattachmentdataPub
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433AlwaysBundledProcedureCodesMA00.026tAdministrative (00)MA00.026tMA00.0260f998311-ad4f-421e-aaf1-953ecc73e058Always Bundled Procedure CodesAlways Bundled Procedure Codes
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387BillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampusMA00.037lAdministrative (00)MA00.037lMA00.037a98a0a5b-faee-4011-916e-6b7e0b0cb2e7Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility CampusBilling for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
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437CareManagementandCarePlanningServicesMA00.006nAdministrative (00)MA00.006nMA00.006eeea6e1f-8b21-4c3b-9764-923b708182faCare Management and Care Planning ServicesCare Management and Care Planning Services
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205CastandSplintApplicationsandAssociatedSuppliesMA00.012cAdministrative (00)MA00.012cMA00.012b86099e5-ed74-4f52-9ab4-c534c779cb23Cast and Splint Applications and Associated SuppliesCast and Splint Applications and Associated Supplies
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206ConsultationServicesMA00.049aAdministrative (00)MA00.049aMA00.04957649d5c-49aa-4216-9686-3c820b5d1237Consultation ServicesConsultation Services
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237ContrastAgentsUsedinConjunctionwithEchocardiographyMA09.004cRadiology (09)MA09.004cMA09.00416379ab5-1c4e-4ad3-9aa8-49dea5cd3d30Contrast Agents Used in Conjunction with EchocardiographyContrast Agents Used in Conjunction with Echocardiography
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38Criteria for Reimbursement of Emergency Room ServicesAdministrative (00)MA00.044bMA00.04485257D39006E7945852584FD00658A7ACriteria for Reimbursement of Emergency Room ServicesCriteria for Reimbursement of Emergency Room Services
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389DirectAccesstoObstetrics/Gynecology(OB/GYN)ServicesMA00.032fAdministrative (00)MA00.032fMA00.0325ee3343f-4d11-4033-86cc-6bc84fb21ce4Direct Access to Obstetrics/Gynecology (OB/GYN) ServicesDirect Access to Obstetrics/Gynecology (OB/GYN) Services
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429DurableMedicalEquipment(DME)MA05.044pDME (05)MA05.044pMA05.044c44eaad0-9cdd-4a02-8da4-75aad160f0c3Durable Medical Equipment (DME)Durable Medical Equipment (DME)
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238DurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximumMA05.028eDME (05)MA05.028eMA05.02881644841-0f55-4dc1-9476-5ab8d631fd3aDurable Medical Equipment (DME) Not Subject to a Rental to Purchase MaximumDurable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum
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243FacilityReportingofObservationServicesMA00.040bAdministrative (00)MA00.040bMA00.040829f9d67-69cd-42ef-98c7-f046756cbf8eFacility Reporting of Observation ServicesFacility Reporting of Observation Services
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321HighOsmolarContrastAgentsMA09.005aRadiology (09)MA09.005aMA09.0057e414ffd-45df-4d01-9363-6562cde82944High Osmolar Contrast AgentsHigh Osmolar Contrast Agents
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207InpatientHospitalReadmissionMA00.023bAdministrative (00)MA00.023bMA00.023bf7dd05e-47c7-4909-abba-e8f25fcac791Inpatient Hospital ReadmissionInpatient Hospital Readmission
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316Instrument-BasedVisionScreeningMA07.048aMedicine (07)MA07.048aMA07.048c9388493-27eb-4cf4-bf9f-6916792f003eInstrument-Based Vision ScreeningInstrument-Based Vision Screening
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26Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other SubstancesAdministrative (00)MA00.022MA00.02285257D39006E79458525847100593A59Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other SubstancesIntravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances
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320LowOsmolarContrastAgentsMA09.008aRadiology (09)MA09.008aMA09.0081f017774-27b5-4e40-b888-b50219a82b0bLow Osmolar Contrast AgentsLow Osmolar Contrast Agents
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383MagneticResonanceImaging(MRI)ContrastAgentsMA09.010eRadiology (09)MA09.010eMA09.010b3e6d4bd-3857-482f-b8fe-382d2592a05eMagnetic Resonance Imaging (MRI) Contrast AgentsMagnetic Resonance Imaging (MRI) Contrast Agents
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233Modifier24:UnrelatedEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringaPostoperativePeriodMA03.009eClinical Logic (03)MA03.009eMA03.0097c7a87e2-ec6e-4784-b62c-646710563f53Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative PeriodModifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
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423Modifier25:Significant,SeparatelyIdentifiableEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalontheSameDayoftheProcedureorOtherServiceMA03.003nClinical Logic (03)MA03.003nMA03.0031506ee5d-44dd-4734-9976-5bfa8af5402aModifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other ServiceModifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
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417Modifier50:BilateralProcedureMA03.002pClinical Logic (03)MA03.002pMA03.00269411266-d1d1-4862-922e-c2679172e47aModifier 50: Bilateral ProcedureModifier 50: Bilateral Procedure
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226Modifier52:ReducedServicesMA03.014bClinical Logic (03)MA03.014bMA03.014b3b91395-a317-41de-b416-eb880d28e0c9Modifier 52: Reduced ServicesModifier 52: Reduced Services
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225Modifier53:DiscontinuedProcedureMA03.018bClinical Logic (03)MA03.018bMA03.01878b314b5-371e-497f-a26b-8462a03d2d6bModifier 53: Discontinued ProcedureModifier 53: Discontinued Procedure
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235Modifier57:DecisionforSurgeryMA03.010eClinical Logic (03)MA03.010eMA03.0103967153e-3d87-4efc-bdab-40f3a1f59027Modifier 57:  Decision for SurgeryModifier 57: Decision for Surgery
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418Modifier62:TwoSurgeonsMA00.011qAdministrative (00)MA00.011qMA00.011310e7d3a-d08e-4baf-8891-2d45ad5df2f1Modifier 62: Two SurgeonsModifier 62: Two Surgeons
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342Modifier66:SurgicalTeam00.10.17nAdministrative (00)00.10.17n00.10.178075c0eb-cae3-4198-8235-c37ffc1458ecModifier 66: Surgical TeamModifier 66: Surgical Team
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419Modifier66:SurgicalTeamMA00.014jAdministrative (00)MA00.014jMA00.014e9bc950d-7cc1-41e1-9170-192df7aa0a5dModifier 66: Surgical TeamModifier 66: Surgical Team
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322Modifier76:RepeatProcedureorServicebySamePhysicianorOtherQualifiedHealthCareProfessionalMA03.001bClinical Logic (03)MA03.001bMA03.001108de71a-6f89-49a0-b5ca-4e6efc35f5b7Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care ProfessionalModifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
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234Modifier77:RepeatProcedureorServicebyAnotherPhysicianorOtherQualifiedHealthCareProfessionalMA03.007bClinical Logic (03)MA03.007bMA03.0073d544cfc-22c9-4703-a5fb-49be357d1621Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care ProfessionalModifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional
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229Modifier78:UnplannedReturntotheOperating/ProcedureRoombytheSamePhysicianorOtherQualifiedHealthCareProfessionalFollowingInitialProcedureforaRelatedProcedureDuringthePostoperativePeriodMA03.008cClinical Logic (03)MA03.008cMA03.008871b932b-3206-4e2c-b15e-732c7fc05552Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative PeriodModifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
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228Modifier79:UnrelatedProcedureorServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringthePostoperativePeriodMA03.012dClinical Logic (03)MA03.012dMA03.0124e608449-a0f5-4080-b758-a286fd5284a2Modifier 79:  Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative PeriodModifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
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421Modifiers26(ProfessionalComponent)andTC(TechnicalComponent)MA03.011mClinical Logic (03)MA03.011mMA03.01107eea0fa-d0fb-41a2-9c1e-8b50cb56af3fModifiers 26 (Professional Component) and TC (Technical Component)Modifiers 26 (Professional Component) and TC (Technical Component)
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422ModifiersforAssistant-at-SurgeryServices:80,81,82,andASMA00.015oAdministrative (00)MA00.015oMA00.0152ed646ca-5f83-4f8f-b8aa-91e7d5a9bc1aModifiers for Assistant-at-Surgery Services: 80, 81, 82, and ASModifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
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227ModifiersforSharedorSplitSurgicalServices(Modifiers54,55,56)MA03.017cClinical Logic (03)MA03.017cMA03.017754fd78f-3dcb-4ec4-95b9-c03173e9e155Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56)Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56)
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217ModifiersXE,XS,XP,XU,and59MA03.005cClinical Logic (03)MA03.005cMA03.005e620572c-998f-4299-a512-24568bd07315Modifiers XE, XS, XP, XU, and 59Modifiers XE, XS, XP, XU, and 59
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216MultipleProcedurePaymentReduction(MPPR)onCertainDiagnosticServicesMA01.005gAnesthesia (01)MA01.005gMA01.005fd9441f7-3279-41e1-bde4-0636c6810afaMultiple Procedure Payment Reduction (MPPR) on Certain Diagnostic ServicesMultiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
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438MultipleProcedurePaymentReductionGuidelinesforPhysical,Occupational,andSpeechTherapyServicesMA00.050aAdministrative (00)MA00.050aMA00.05057615dab-e0d9-4064-ad0c-db02855b6b96Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy ServicesMultiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services
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242MultipleSurgeryPaymentReductionMA11.032gSurgery (11)MA11.032gMA11.03214e44a56-51b8-43c2-b8d5-44832b823eb7Multiple Surgery Payment ReductionMultiple Surgery Payment Reduction
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223NationalCorrectCodingInitiative(NCCI)CodePairEditsMA00.041aAdministrative (00)MA00.041aMA00.04153e83cf3-3d26-4d7c-b6e9-e65fe70e798eNational Correct Coding Initiative (NCCI) Code Pair EditsNational Correct Coding Initiative (NCCI) Code Pair Edits
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391PPONetworkRulesforProvisionofSpecialtyServicesforDurableMedicalEquipmentandLaboratory,Radiology,andPhysicalMedicineandRehabilitativeServices00.01.25bmAdministrative (00)00.01.25bm00.01.25007cc62d-5b09-4479-888a-ebe56d887956PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesPPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
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402PPONetworkRulesforProvisionofSpecialtyServicesforDurableMedicalEquipmentandLaboratory,Radiology,andPhysicalMedicineandRehabilitativeServicesMA00.010anAdministrative (00)MA00.010anMA00.010451608d3-8988-426b-a946-992a6687ff29PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesPPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
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203RadiologicGuidanceand/orSupervisionandInterpretationofaProcedureMA00.019jAdministrative (00)MA00.019jMA00.01911e9acd3-0cff-4029-9bfa-0bbe324eed04Radiologic Guidance and/or Supervision and Interpretation of a ProcedureRadiologic Guidance and/or Supervision and Interpretation of a Procedure
{"3731": {"Id":3731,"MPAttachmentLetter":"A","Title":"Radiologic Guidance and Supervision and Interpretation Procedure Codes","MPPolicyAttachmentInternalSourceId":6411,"PolicyAttachmentPageName":"dd02e5cb-e5c6-49fd-b80b-8496697ce84f"},}
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315ReimbursementforanIntraocularLensMA11.043aSurgery (11)MA11.043aMA11.043de6354bf-ee91-4e6b-b58a-42d22350b7a6Reimbursement for an Intraocular LensReimbursement for an Intraocular Lens
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317ReimbursementforComponentsofComprehensiveLaboratoryPanelsMA01.006aAnesthesia (01)MA01.006aMA01.00627dfc768-a6c5-4bb2-bcad-af6af286f7d0Reimbursement for Components of Comprehensive Laboratory PanelsReimbursement for Components of Comprehensive Laboratory Panels
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245ReimbursementfortheAdministrationofImmunizationsMA07.019bMedicine (07)MA07.019bMA07.0191e93764f-529e-41b2-9a1d-90e82cfe5933Reimbursement for the Administration of ImmunizationsReimbursement for the Administration of Immunizations
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427RepairandReplacementofDurableMedicalEquipment(DME)andProstheticDevicesMA05.062jDME (05)MA05.062jMA05.0621db75e7b-824a-4841-bcbb-1762ea2edd6fRepair and Replacement of Durable Medical Equipment (DME) and Prosthetic DevicesRepair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices
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385ReportingandDocumentationRequirementsforAnesthesiaServicesMA00.009hAdministrative (00)MA00.009hMA00.009fdae72fc-2278-473c-bee5-78d7a931a048Reporting and Documentation Requirements for Anesthesia ServicesReporting and Documentation Requirements for Anesthesia Services
{"386": {"Id":386,"MPAttachmentLetter":"A","Title":"ASA Anesthesia Procedure Codes","MPPolicyAttachmentInternalSourceId":7906,"PolicyAttachmentPageName":"916c89e8-5615-43f9-ae62-0b94c2d45873"},}
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413Rituximab(Rituxan®)InfusionandRelatedBiosimilars,andRituximab/HyaluronidaseHumanforSubcutaneousInjection(RituxanHycela®)08.00.50acPharmacy (08)08.00.50ac08.00.50def96ce9-b2ef-446a-bfc7-ae6c511328cdRituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
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369ServicesPaidAboveCapitationforHealthMaintenanceOrganization(HMO)andHealthMaintenanceOrganizationPoint-of-Service(HMO-POS)PrimaryCareProvidersMA00.033oAdministrative (00)MA00.033oMA00.0332d997ee4-fb5b-4de2-9ca2-63b77e6988d7Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care ProvidersServices Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
{"370": {"Id":370,"MPAttachmentLetter":"A: PENNSYLVANIA","Title":"Pennsylvania Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers","MPPolicyAttachmentInternalSourceId":7874,"PolicyAttachmentPageName":"71802772-d6ed-4561-b6b4-7ff2388dd4fc"},"371": {"Id":371,"MPAttachmentLetter":"B: NEW JERSEY","Title":"New Jersey Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers","MPPolicyAttachmentInternalSourceId":7875,"PolicyAttachmentPageName":"b3c9d5f8-74b1-4405-9729-2840a8708e26"},}
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323UseofaRobotic-AssistedSurgicalSystemMA11.057bSurgery (11)MA11.057bMA11.0570cdfcd0f-4f8f-4c85-abd8-0cfd327fe080Use of a Robotic-Assisted Surgical SystemUse of a Robotic-Assisted Surgical System
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232X-raysAssociatedwithFracturesintheOfficeSettingMA00.031eAdministrative (00)MA00.031eMA00.0312f1a7441-4106-4e9e-9a22-ad39ab0fcc65X-rays Associated with Fractures in the Office SettingX-rays Associated with Fractures in the Office Setting
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