Key facts for NCD 30.1.1
- Benefit category
- Incident to a physician's professional Service, Outpatient Physical Therapy Services, Physicians' Services
- Effective date
- 07/01/2001
- Implemented 07/01/2001
- Transmittal
- Transmittal 138
- Versions published
- 1
- Manual chapter
- 30
- NCD Manual (Pub. 100-03)
TL;DR
NCD 30.1.1 sets Medicare's national policy for biofeedback therapy for the treatment of urinary incontinence under the benefit category "Incident to a physician's professional Service, Outpatient Physical Therapy Services, Physicians' Services", effective 07/01/2001 and implemented 07/01/2001. This policy applies to biofeedback therapy rendered by a practitioner in an office or other facility setting. It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Indications and limitations of coverage
This policy applies to biofeedback therapy rendered by a practitioner in an office or other facility setting.
Biofeedback is covered for the treatment of stress and/or urge incontinence in cognitively intact patients who have failed a documented trial of pelvic muscle exercise (PME) training. Biofeedback is not a treatment, per se, but a tool to help patients learn how to perform PME. Biofeedback-assisted PME incorporates the use of an electronic or mechanical device to relay visual and/or auditory evidence of pelvic floor muscle tone, in order to improve awareness of pelvic floor musculature and to assist patients in the performance of PME.
A failed trial of PME training is defined as no clinically significant improvement in urinary incontinence after completing 4 weeks of an ordered plan of pelvic muscle exercises to increase periurethral muscle strength.
Contractors may decide whether or not to cover biofeedback as an initial treatment modality.
Home use of biofeedback therapy is not covered.
Text reproduced from the CMS Medicare Coverage Database record for NCD 30.1.1 version 1. View the original on cms.gov.
Revision history
05/15/2001 - Deliniated coverage policy. Effective and implementation dates 07/01/2001. ( TN 138 ) (CR 1535)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 30.1.1
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 30.1.1
What does NCD 30.1.1 cover?
This policy applies to biofeedback therapy rendered by a practitioner in an office or other facility setting. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 30.1.1 take effect?
The current version (1) is effective 07/01/2001, implemented 07/01/2001, published in transmittal 138. This is the only published version.
Does a Local Coverage Determination override NCD 30.1.1?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
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.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.