Are Medicare Benefits Determined Nationally? If so, what are Local Coverage Determinations?
For most categories of services covered, Medicare pays for “reasonable and necessary” services. This definitions, however, is fairly vague. CMS does issue about 20 national coverage determinations (NCDs) each year to clarify which services are permitted. [Here is a list of the CMS’s pending national coverage analyses]. Foote et al. (2008) elaborate on how NCDs are implemented. CMS can…