Key facts for NCD 70.2
- Benefit category
- Physicians' Services
- Effective date
- This is a longstanding national coverage determination. The effective date of this version has not been posted.
- Transmittal
- Transmittal 36
- Versions published
- 1
- Manual chapter
- 70
- NCD Manual (Pub. 100-03)
TL;DR
NCD 70.2 sets Medicare's national policy for consultation services rendered by a podiatrist in a skilled nursing facility under the benefit category "Physicians' Services", effective This is a longstanding national coverage determination. The effective date of this version has not been posted.. Consultation services rendered by a podiatrist in a skilled nursing facility are covered if the services are reasonable and necessary and do not come within any of the specific statutory exclusions. Section 1862(a)(13) of the Act excludes payment for the… It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Indications and limitations of coverage
Consultation services rendered by a podiatrist in a skilled nursing facility are covered if the services are reasonable and necessary and do not come within any of the specific statutory exclusions. Section 1862(a)(13) of the Act excludes payment for the treatment of flat foot conditions, the treatment of subluxations of the foot, and routine foot care. To determine whether the consultation comes within the foot care exclusions, apply the same rule as for initial diagnostic examinations, i.e., where services are performed in connection with specific symptoms or complaints which suggest the need for covered services, the services are covered regardless of the resulting diagnosis. The exclusion of routine physician examinations is also pertinent and would generally exclude podiatric consultation performed on all patients in a skilled nursing facility on a routine basis for screening purposes, except in those cases where a specific foot ailment is involved. Section 1862(a)(7) of the Act excludes payment for routine physical checkups.
Text reproduced from the CMS Medicare Coverage Database record for NCD 70.2 version 1. View the original on cms.gov.
Revision history
05/1989 - Added statutory authority citation. Effective date NA. (TN 36)
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 70.2
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 70.2
What does NCD 70.2 cover?
Consultation services rendered by a podiatrist in a skilled nursing facility are covered if the services are reasonable and necessary and do not come within any of the specific statutory exclusions. Section 1862(a)(13) of the Act excludes payment for the treatment of flat foot conditions, the treatment of subluxations of the foot, and routine foot care. To determine whether the consultation comes within the foot… The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 70.2 take effect?
The current version (1) is effective This is a longstanding national coverage determination. The effective date of this version has not been posted., published in transmittal 36. This is the only published version.
Does a Local Coverage Determination override NCD 70.2?
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.