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Wisconsin Physicians Service Insurance Corporation: Medicare jurisdictions and Local Coverage Determinations

Wisconsin Physicians Service Insurance Corporation administers Medicare fee-for-service claims in 48 states and territories through 13 contracts, and maintains 113 active Local Coverage Determinations in the current Medicare Coverage Database export. Each LCD below applies only inside this contractor's jurisdiction; the same service can be covered under different criteria by the neighbouring MAC.

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective

Key facts

Active LCDs
113
Contracts
13
05101, 05102, 05201, 05202, 05301, 05302, 05401, 05402, 05901, 08101, 08102, 08201, 08202
States and territories
48
AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NM NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Contractor site
med.wpsgha.com/

Jurisdictions

Contract numbers identify the jurisdiction on remittances and in the Medicare Coverage Database; A and B MAC contracts cover both institutional and professional claims, while DME and HHH contracts are national or regional specialty jurisdictions.

Medicare contracts held by Wisconsin Physicians Service Insurance Corporation
ContractTypeStates
05101MAC - Part AIA
05102MAC - Part BIA
05201MAC - Part AKS
05202MAC - Part BKS
05301MAC - Part AMO
05302MAC - Part BMO
05401MAC - Part ANE
05402MAC - Part BNE
05901MAC - Part AAK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NM NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
08101MAC - Part AIN
08102MAC - Part BIN
08201MAC - Part AMI
08202MAC - Part BMI

Most recently effective LCDs

Revision effective dates signal where this contractor has tightened or loosened criteria; the ten newest are listed first, with the full list below.

Ten most recently effective LCDs from Wisconsin Physicians Service Insurance Corporation
LCDTitleEffective
L40300Peripheral Nerve Injections and Procedures for Chronic Pain2026-10-25
L40274MolDX: Genetic Testing for Hereditary Thrombophilia2026-10-12
L40278MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer2026-10-12
L40341Allergy Diagnostic Testing2026-09-27
L38441MolDX: Blood Product Molecular Antigen Typing2026-09-24
L40249MolDX: Molecular Testing for Solid Organ Allograft Rejection2026-08-30
L34614Colonoscopy and Sigmoidoscopy-Diagnostic2026-08-27
L39051Cosmetic and Reconstructive Surgery2026-08-27
L39907Micro-Invasive Glaucoma Surgery (MIGS)2026-08-27
L39911Total Joint Arthroplasty2026-08-27

All active LCDs (113)

How to use this contractor's policies

A Local Coverage Determination applies only to claims processed by the contractor that wrote it, so the first question is which jurisdiction the rendering location falls in; the contracts table above answers that for institutional and professional claims, and durable medical equipment follows the DME MAC region instead. Each LCD states the covered indications, the documentation the record must contain and, through its companion Billing and Coding Article, the ICD-10 codes that support medical necessity and the HCPCS codes the policy edits. When a claim denies with CARC 50 and remark N115, the remark names the LCD; open it from the list above, compare the diagnosis on the claim with the article's covered list, and build the appeal on the documentation requirements rather than on the policy itself. Where this contractor has no LCD for a service and no National Coverage Determination exists, coverage is decided claim by claim under the reasonable-and-necessary standard, which is where prior authorization and pre-service review earn their keep.

Frequently asked questions

Which states does Wisconsin Physicians Service Insurance Corporation cover?

Wisconsin Physicians Service Insurance Corporation holds 13 Medicare contracts (05101 MAC - Part A; 05102 MAC - Part B; 05201 MAC - Part A; 05202 MAC - Part B; 05301 MAC - Part A; 05302 MAC - Part B; 05401 MAC - Part A; 05402 MAC - Part B; 05901 MAC - Part A; 08101 MAC - Part A; 08102 MAC - Part B; 08201 MAC - Part A; 08202 MAC - Part B) covering AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY.

How many LCDs does Wisconsin Physicians Service Insurance Corporation have?

113 Local Coverage Determinations are active in the current Medicare Coverage Database export for Wisconsin Physicians Service Insurance Corporation. Each LCD applies only in that contractor's jurisdiction, so the same service can be covered differently in a neighbouring state.

What is the difference between an LCD and an NCD?

A National Coverage Determination is set by CMS and binds every contractor. A Local Coverage Determination is written by one Medicare Administrative Contractor for its jurisdiction and cannot conflict with an NCD; where no NCD exists, the LCD is the controlling policy.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Contractor jurisdictions and LCD lists are reproduced from the CMS Medicare Coverage Database export as an operational reference. Verify coverage against the current LCD text on cms.gov or the contractor site before billing. Not legal, clinical or billing advice.