The Centers for Medicare and Medicaid Services (CMS) publishes requirements for Medicare-covered services and procedures in documents called National Coverage Determinations (NCDs). An NCD is a nationwide determination of whether Medicare will pay for an item or service, and an NCD includes descriptions of provider, documentation, and indication requirements for payment. CMS creates NCDs through evidence-based analysis with opportunities for public participation in reviewing drafts. Currently, approximately 340 published NCDs describe requirements to receive federally funded reimbursement dollars for particular services.

Maintaining awareness of requirements for services delivered in your operational area(s) proves useful in supporting providers, staff, Revenue Cycle, and the rest of the institution in proactively meeting criteria to receive federal reimbursements for clinical care. A complete list of NCDs can be found in the CMS National Coverage NCD Report.

If you have any questions about requirements for services delivered in your area, please contact the Office of Healthcare Compliance & Privacy at ohcp@uchc.edu or x6060.