Coverage policy
What Medicare has decided it covers, where you live
Medicare publishes its coverage rules as documents. This searches the real ones, live, and tells you which contractor writes them for your state.
What this is
When Medicare decides whether it will pay for a particular test, device or procedure, it writes the decision down. A national decision is a National Coverage Determination. A regional one is a Local Coverage Determination, usually shortened to LCD, and it is written by the private company Medicare pays to process claims in your part of the country. That company is called a Medicare Administrative Contractor, or MAC.
This matters because the same item can be covered in one state and not in the next. The box below searches every final Local Coverage Determination that Medicare currently publishes, and every billing and coding article attached to them, and lets you narrow it to the contractor that serves your state.
What it is not
It is not a check against your plan, and it is not a promise that anything will be paid. A coverage policy says what is covered in principle. Whether your own claim is paid also depends on your diagnosis, your documentation, whether the item was medically necessary for you, and whether your provider takes assignment. For a real answer about your own care, call 1-800-MEDICARE or your plan.
Demonstration site. The search below is real and pulls live from the Medicare Coverage Database at api.coverage.cms.gov. Everything else about this company is invented. Nothing you type here is sent anywhere or stored.
If a policy says no
A coverage policy is not the end of the conversation. If Medicare or your plan refuses to pay for something, you have a formal right to appeal, and a lot of refusals are overturned. Call us and we will read the policy with you.
Search the coverage database
Every final Local Coverage Determination Medicare publishes, plus the billing and coding articles attached to them. Fetched once, cached, and searched here in your browser.
Loading the coverage database.
Nothing matched
The coverage database is not answering
You can search the same documents directly at cms.gov/medicare-coverage-database , or call 1-800-MEDICARE.
Who writes coverage policy where
Eight companies hold Medicare's claims contracts between them. The database names the company on each document but not the jurisdiction, so this table is how a state filter is possible at all. It is transcribed by hand from CMS's published jurisdiction map and last checked in 2026-09.
| Contractor | Contract | Jurisdiction | Places |
|---|---|---|---|
| Noridian Healthcare Solutions | Hospital and doctor claims (Part A and Part B) | JE | CA, HI, NV, AS, GU, MP |
| Hospital and doctor claims (Part A and Part B) | JF | AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY | |
| Equipment, supplies and prosthetics (DME) | DME A | CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT | |
| Equipment, supplies and prosthetics (DME) | DME D | AK, AZ, CA, HI, IA, ID, KS, MO, MT, NE, NV, ND, OR, SD, UT, WA, WY, AS, GU, MP | |
| Home health and hospice | HH+H West | AK, AZ, CA, HI, ID, NV, OR, WA, AS, GU, MP | |
| Palmetto GBA | Hospital and doctor claims (Part A and Part B) | JJ | AL, GA, TN |
| Hospital and doctor claims (Part A and Part B) | JM | NC, SC, VA, WV | |
| Home health and hospice | HH+H JM | AL, AR, FL, GA, LA, MS, NM, NC, OK, SC, TN, TX, VA, WV | |
| CGS Administrators | Hospital and doctor claims (Part A and Part B) | J15 | KY, OH |
| Equipment, supplies and prosthetics (DME) | DME B | IL, IN, KY, MI, MN, OH, WI | |
| Equipment, supplies and prosthetics (DME) | DME C | AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, WV | |
| Home health and hospice | HH+H J15 | CO, DE, DC, IN, IA, KS, KY, MD, MO, MT, NE, NJ, ND, OH, PA, PR, SD, UT, VI, WY | |
| WPS Government Health Administrators | Hospital and doctor claims (Part A and Part B) | J5 | IA, KS, MO, NE |
| Hospital and doctor claims (Part A and Part B) | J8 | IN, MI | |
| Wellpoint Federal Administrators | Hospital and doctor claims (Part A and Part B) | J6 | IL, MN, WI |
| Hospital and doctor claims (Part A and Part B) | JK | CT, ME, MA, NH, NY, RI, VT | |
| Home health and hospice | HH+H J6 | CT, IL, ME, MA, MI, MN, NH, NY, RI, VT, WI | |
| National Government Services | Hospital and doctor claims (Part A and Part B) | J6 | IL, MN, WI |
| Hospital and doctor claims (Part A and Part B) | JK | CT, ME, MA, NH, NY, RI, VT | |
| Home health and hospice | HH+H J6 | CT, IL, ME, MA, MI, MN, NH, NY, RI, VT, WI | |
| Novitas Solutions | Hospital and doctor claims (Part A and Part B) | JH | AR, CO, LA, MS, NM, OK, TX |
| Hospital and doctor claims (Part A and Part B) | JL | DE, DC, MD, NJ, PA | |
| First Coast Service Options | Hospital and doctor claims (Part A and Part B) | JN | FL, PR, VI |
One thing the data cannot tell you
Five of these companies hold two jurisdictions each. Noridian writes for both the west coast and the mountain states; Palmetto writes for both the deep south and the mid Atlantic. The database says which company wrote a policy, but not which of its two territories the policy was written for. So a state filter here means "written by the company that serves your state", which is the right first cut, and the document itself is where you confirm it. We would rather say that than round it up into a certainty.
Before you act on anything you find here
Two rules, and they are the reason this page is framed the way it is.
A retired policy is not the current rule. Retired documents stay in the database, they are still indexed by search engines, and people quote them years later in good faith. Every retired document in these results is marked, in red, with the date it was retired.
Coverage in principle is not payment in practice. The only people who can tell you whether your own claim will be paid are Medicare and your plan. Call 1-800-MEDICARE, 24 hours a day, seven days a week. TTY 1-877-486-2048.
Required notice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.