Open for comment
19 proposals across 8 topics accept written comments today. Several contractors often propose the same policy at once, so a topic can carry one proposal per contractor, each with its own deadline and jurisdictions. The deadline column counts from today; the proposal ID opens the record on cms.gov, which names the contact for comments.
MolDX: Genome-Wide Molecular Methodologies for the Detection of Copy Number Alterations and Structural Variants in Hematologic Neoplasms
1 open proposal from Wisconsin Physicians Service Insurance Corporation, reaching 48 states and territories; the earliest deadline is November 7, 2026 (closes in 25 days). No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40474 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Sep 24, 2026 to Nov 7, 2026 | closes in 25 days | New policy |
This LCD outlines limited coverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40474)
MolDX: Next-Generation Sequencing for Hematologic Malignancies and Suspected Hematologic Malignancies
1 open proposal from Wisconsin Physicians Service Insurance Corporation, reaching 48 states and territories; the earliest deadline is November 7, 2026 (closes in 25 days). No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40472 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Sep 24, 2026 to Nov 7, 2026 | closes in 25 days | New policy |
This LCD outlines limited coverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40472)
MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in Renal Carcinoma
1 open proposal from Wisconsin Physicians Service Insurance Corporation, reaching 48 states and territories; the earliest deadline is November 7, 2026 (closes in 25 days). No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40470 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Sep 24, 2026 to Nov 7, 2026 | closes in 25 days | New policy |
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40470)
Automated Detection and Quantification of Brain MRIs
2 open proposals from Noridian Healthcare Solutions, LLC; Palmetto GBA, reaching 23 states and territories; the earliest deadline is November 14, 2026 (closes in 32 days). The active policy on this topic is L40224.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40454 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40464 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity. (issue statement, DL40454, DL40464)
Hyaluronic Acid Injections for Knee Osteoarthritis
1 open proposal from Noridian Healthcare Solutions, LLC, reaching 16 states and territories; the earliest deadline is November 14, 2026 (closes in 32 days). The active policy on this topic is L39260.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40456 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
This Local Coverage Determination (LCD) outlines limited coverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40456)
Near-Infrared Spectroscopy in Wound and Flap Management
5 open proposals from Palmetto GBA; Noridian Healthcare Solutions, LLC; CGS Administrators, LLC; Wellpoint Federal; Wisconsin Physicians Service Insurance Corporation, reaching 53 states and territories; the earliest deadline is November 14, 2026 (closes in 32 days). The active policy on this topic is L39385.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL39385 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | Revises L39385 |
| DL40458 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40466 | CGS Administrators, LLC (4 contracts) | KY OH | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40477 | Wellpoint Federal (22 contracts) | CT IL MA ME MN NH NY RI VT WI | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40479 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL39385, DL40458, DL40466, DL40479)
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity. (issue statement, DL40477)
Real-Time Fluorescence Wound Imaging for Bacterial Presence
7 open proposals from Novitas Solutions, Inc.; First Coast Service Options, Inc.; Wisconsin Physicians Service Insurance Corporation; Wellpoint Federal; Noridian Healthcare Solutions, LLC; Palmetto GBA; CGS Administrators, LLC, reaching 56 states and territories; the earliest deadline is November 14, 2026 (closes in 32 days). No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40413 | Novitas Solutions, Inc. (26 contracts) | 12 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40415 | First Coast Service Options, Inc. (5 contracts) | FL PR VI | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40437 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40439 | Wellpoint Federal (22 contracts) | CT IL MA ME MN NH NY RI VT WI | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40441 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40443 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
| DL40468 | CGS Administrators, LLC (4 contracts) | KY OH | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
This is a contractor-initiated Local Coverage Determination (LCD) developed to establish that the available evidence and accepted standards of clinical practice do not support the use of real-time fluorescence wound imaging (RTFI) for locating bacterial pathogens in wound management. RTFI has not demonstrated a clinically meaningful benefit in the treatment of wounds, nor has it been shown to improve patient health outcomes. (issue statement, DL40413, DL40415, DL40437, DL40439, DL40441, DL40443, DL40468)
Surgical Treatment of Nails
1 open proposal from Noridian Healthcare Solutions, LLC, reaching 16 states and territories; the earliest deadline is November 14, 2026 (closes in 32 days). Today's versions of this policy are compared on the Surgical Treatment of Nails topic page.
| Proposal | Contractor | States | Comment period | Deadline | Scope |
|---|---|---|---|---|---|
| DL40462 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 1, 2026 to Nov 14, 2026 | closes in 32 days | New policy |
This Local Coverage Determination (LCD) outlines limited coverage for this service, with specific details under Coverage Indications, Limitations, and/or Medical Necessity (issue statement, DL40462)
Comment closed, awaiting a final LCD
34 pending proposals no longer take comments and have no final version in the export. The contractor reviews the comments, holds its open meeting and then publishes the final LCD or retires the proposal. The decision column is one year after the proposal was published, the window the Program Integrity Manual sets for that choice; 4 of these have passed it and still show as proposed in the database.
Automated Detection and Quantification of Brain MRIs
1 proposal from National Government Services, Inc., comment period closed March 8, 2026. The active policy on this topic is L40224.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40332 | National Government Services, Inc. (22 contracts) | CT IL MA ME MN NH NY RI VT WI | Mar 8, 2026 | Jan 22, 2027 | New policy |
Non-coverage Article for Automated Detection and Quantification of Brain MRIs (issue statement, DL40332)
Botulinum Toxin Injections
6 proposals from Noridian Healthcare Solutions, LLC; National Government Services, Inc.; Palmetto GBA; Wisconsin Physicians Service Insurance Corporation; CGS Administrators, LLC, comment periods closed May 16, 2026; June 6, 2026. Today's versions of this policy are compared on the Botulinum Toxin Injections topic page.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL35170 | Noridian Healthcare Solutions, LLC (8 contracts) | AS CA GU HI MP NV | May 16, 2026 | Apr 2, 2027 | Revises L35170 |
| DL35172 | Noridian Healthcare Solutions, LLC (20 contracts) | AK AZ ID MT ND OR SD UT WA WY | May 16, 2026 | Apr 2, 2027 | Revises L35172 |
| DL39832 | National Government Services, Inc. (22 contracts) | CT IL MA ME MN NH NY RI VT WI | May 16, 2026 | Apr 2, 2027 | Revises L39832 |
| DL39836 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | May 16, 2026 | Apr 2, 2027 | Revises L39836 |
| DL39909 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | May 16, 2026 | Apr 2, 2027 | Revises L39909 |
| DL39857 | CGS Administrators, LLC (4 contracts) | KY OH | Jun 6, 2026 | Apr 23, 2027 | Revises L39857 |
This updated Botulinum Toxin Injections Local Coverage Determination provides clarification regarding adherence to FDA label changes and Dosing Guideline requirements for serotypes. (issue statement, DL35170, DL35172, DL39832, DL39836, DL39909, DL39857)
Computed Tomography Cerebral Perfusion Analysis (CTP)
1 proposal from Wisconsin Physicians Service Insurance Corporation, comment period closed March 14, 2026. Today's versions of this policy are compared on the Computed Tomography Cerebral Perfusion Analysis (CTP) topic page.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40343 | Wisconsin Physicians Service Insurance Corporation (1 contract) | IA | Mar 14, 2026 | Jan 29, 2027 | New policy |
This LCD outlines limited coverage for this service with specific details under Coverage Indications, Limitations, and/or Medical Necessity. (issue statement, DL40343)
External Breast Prostheses
1 proposal from CGS Administrators, LLC; Noridian Healthcare Solutions, LLC, comment period closed September 5, 2026. The active policy on this topic is L33317.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL33317 | CGS Administrators, LLC (2 contracts); Noridian Healthcare Solutions, LLC (2 contracts) | 56 states and territories | Sep 5, 2026 | Jul 23, 2027 | Revises L33317 |
The proposed LCD proposes the removal of the not reasonable and necessary determination for breast prostheses, silicone or equal, with integral adhesive. (issue statement, DL33317)
Facet Joint Interventions for Pain Management
2 proposals from First Coast Service Options, Inc.; Novitas Solutions, Inc., comment periods closed August 22, 2026. Today's versions of this policy are compared on the Facet Joint Interventions for Pain Management topic page.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL33930 | First Coast Service Options, Inc. (5 contracts) | FL PR VI | Aug 22, 2026 | Jul 9, 2027 | Revises L33930 |
| DL34892 | Novitas Solutions, Inc. (26 contracts) | 12 states and territories | Aug 22, 2026 | Jul 9, 2027 | Revises L34892 |
This change expands coverage by reducing the criteria for repeat facet joint radiofrequency ablation (RFA) from two requirements to one. Specifically, “and” is replaced with “or” in the coverage indications, allowing either improvement in pain or improvement in the ability to perform previously painful movements and activities of daily living (ADLs). (issue statement, DL33930, DL34892)
MolDX: Biomarker Testing for Risk Stratification in DCIS
4 proposals from Palmetto GBA; Noridian Healthcare Solutions, LLC; CGS Administrators, LLC; Wisconsin Physicians Service Insurance Corporation, comment periods closed August 31, 2025. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40142 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Aug 31, 2025 | Jul 17, 2026 (passed) | New policy |
| DL40144 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Aug 31, 2025 | Jul 17, 2026 (passed) | New policy |
| DL40246 | CGS Administrators, LLC (4 contracts) | KY OH | Aug 31, 2025 | Jul 17, 2026 (passed) | New policy |
| DL40251 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Aug 31, 2025 | Jul 17, 2026 (passed) | New policy |
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity. (issue statement, DL40142, DL40144)
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40246)
MolDX: Genome-Wide Molecular Methodologies for the Detection of Copy Number Alterations and Structural Variants in Hematologic Neoplasms
3 proposals from Palmetto GBA; Noridian Healthcare Solutions, LLC; CGS Administrators, LLC, comment periods closed October 11, 2026. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40407 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40411 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40431 | CGS Administrators, LLC (4 contracts) | KY OH | Oct 11, 2026 | Aug 27, 2027 | New policy |
This LCD outlines limited coverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40407, DL40411, DL40431)
MolDX: Next-Generation Sequencing for Hematologic Malignancies and Suspected Hematologic Malignancies
3 proposals from Palmetto GBA; Noridian Healthcare Solutions, LLC; CGS Administrators, LLC, comment periods closed October 11, 2026. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40425 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40427 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40451 | CGS Administrators, LLC (4 contracts) | KY OH | Oct 11, 2026 | Aug 27, 2027 | New policy |
This LCD outlines limited coverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40425, DL40427, DL40451)
MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in Renal Carcinoma
3 proposals from Palmetto GBA; CGS Administrators, LLC; Noridian Healthcare Solutions, LLC, comment periods closed October 11, 2026. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40429 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40433 | CGS Administrators, LLC (4 contracts) | KY OH | Oct 11, 2026 | Aug 27, 2027 | New policy |
| DL40435 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Oct 11, 2026 | Aug 27, 2027 | New policy |
This LCD outlines noncoverage for this service with specific details under Coverage Indications, Limitations and/or Medical Necessity . (issue statement, DL40429, DL40433, DL40435)
Oxygen and Oxygen Equipment
1 proposal from CGS Administrators, LLC; Noridian Healthcare Solutions, LLC, comment period closed September 5, 2026. The active policy on this topic is L33797.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL33797 | CGS Administrators, LLC (2 contracts); Noridian Healthcare Solutions, LLC (2 contracts) | 56 states and territories | Sep 5, 2026 | Jul 23, 2027 | Revises L33797 |
The proposed LCD proposes reasonable and necessary coverage criteria for topical oxygen therapy for Medicare beneficiaries with diabetic foot ulcers that have failed to heal with four consecutive weeks of optimized diabetic foot ulcer care. (issue statement, DL33797)
Power Mobility Devices
1 proposal from CGS Administrators, LLC; Noridian Healthcare Solutions, LLC, comment period closed April 4, 2026. The active policy on this topic is L33789.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL33789 | CGS Administrators, LLC (2 contracts); Noridian Healthcare Solutions, LLC (2 contracts) | 56 states and territories | Apr 4, 2026 | Feb 19, 2027 | Revises L33789 |
The proposed LCD proposes a not reasonable and necessary determination for Group 2 power wheelchairs (PWCs) with seat elevation systems (K0830 and K0831), based on the best available evidence. Per the National Coverage Determination (NCD) 280.16 Seat Elevation Equipment (Power Operated) on Power Wheelchairs, coverage of Group 2 PWCs with seat elevators would be determined at the MAC’s discretion. (issue statement, DL33789)
Proposed LCD DL40356 and related proposals (title quotes a CPT descriptor licensed by the AMA)
5 proposals from CGS Administrators, LLC; Noridian Healthcare Solutions, LLC; National Government Services, Inc.; Palmetto GBA; Wisconsin Physicians Service Insurance Corporation, comment periods closed July 4, 2026. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40356 | CGS Administrators, LLC (4 contracts) | KY OH | Jul 4, 2026 | May 21, 2027 | New policy |
| DL40359 | Noridian Healthcare Solutions, LLC (28 contracts) | 16 states and territories | Jul 4, 2026 | May 21, 2027 | New policy |
| DL40363 | National Government Services, Inc. (22 contracts) | CT IL MA ME MN NH NY RI VT WI | Jul 4, 2026 | May 21, 2027 | New policy |
| DL40367 | Palmetto GBA (14 contracts) | AL GA NC SC TN VA WV | Jul 4, 2026 | May 21, 2027 | New policy |
| DL40385 | Wisconsin Physicians Service Insurance Corporation (13 contracts) | 48 states and territories | Jul 4, 2026 | May 21, 2027 | New policy |
Multi-MAC initiated policy to address evidence based utilization coverage for this device. (issue statement, DL40356, DL40385)
Multi-MAC initiated policy to address evidence-based utilization coverage for this device. (issue statement, DL40363)
Urine-based Biomarkers in Patients with Microhematuria
2 proposals from Novitas Solutions, Inc.; First Coast Service Options, Inc., comment periods closed July 18, 2026. No contractor has a final LCD with this title yet, so every proposal here would create a new policy.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL40378 | Novitas Solutions, Inc. (26 contracts) | 12 states and territories | Jul 18, 2026 | May 14, 2027 | New policy |
| DL40380 | First Coast Service Options, Inc. (5 contracts) | FL PR VI | Jul 18, 2026 | May 14, 2027 | New policy |
This contractor undertook policy development to address reconsideration requests to expand coverage for urine-based biomarkers (UBBs) in the setting of microhematuria (MH) specifically related to the risk-stratification of patients being evaluated for urothelial carcinoma (UC), modernize and align policies across jurisdictions, and ensure guidance does not conflict with national policies or LCDs developed by the A/B MAC national workgroup (NWG). (issue statement, DL40378, DL40380)
Wheelchair Options/Accessories
1 proposal from CGS Administrators, LLC; Noridian Healthcare Solutions, LLC, comment period closed April 4, 2026. The active policy on this topic is L33792.
| Proposal | Contractor | States | Comments closed | Finalize or retire by | Scope |
|---|---|---|---|---|---|
| DL33792 | CGS Administrators, LLC (2 contracts); Noridian Healthcare Solutions, LLC (2 contracts) | 56 states and territories | Apr 4, 2026 | Feb 19, 2027 | Revises L33792 |
The proposed LCD proposes a not reasonable and necessary determination for the use of seat elevation added onto non-complex power wheelchairs, based on the best available evidence. The proposed LCD proposes to include, in the coverage criteria for power tilt and/or recline seating systems, examples of clinical conditions that limit the beneficiary’s ability to perform a functional weight shift. (issue statement, DL33792)
How a proposed LCD becomes final
Chapter 13 of the Medicare Program Integrity Manual (Pub. 100-08) sets the steps. A contractor publishes the proposed LCD on the Medicare Coverage Database, which starts the public process, and gives at least 45 calendar days for written comment (section 13.2.4.2). During that time it holds an open meeting where interested parties can present the evidence (section 13.2.4.4); its Contractor Advisory Committee exists to review the quality of the evidence behind LCDs (section 13.2.4.3).
After the comment period the contractor publishes the final LCD and, on the same day, a Response to Comments article answering the comments it received (sections 13.2.5 and 13.2.5.1). Publication of the final LCD opens a notice period of at least 45 calendar days; unless it is extended, the policy takes effect on the 46th day (section 13.2.6). A proposal that is never finalized does not linger by design: contractors must finalize or retire every proposed LCD within a rolling year of its publication date (section 13.5.6). The Program Integrity Manual guides cover the other chapters of the same manual.
For a billing team the dates that matter are the comment deadline, if the change affects a service you provide, and the effective date of the final version, from which claims are edited against the new criteria and code lists. The weekly Medicare Coverage Database digest lists final LCDs as they are posted for notice, and the policy pages show a pending-revision notice while a proposal is pending.
Proposals finalised in the last six months
39 proposals were posted as a final LCD in the last 180 days, out of 63 finalised proposals the export still lists. They are left out of the tracker above; the final policy and its effective date are here.
| Proposal | Title | Final LCD | Notice period from | Effective |
|---|---|---|---|---|
| DL40265 | Peripheral Nerve Blocks and Procedures for Chronic Pain | L40265 | Sep 17, 2026 | Nov 1, 2026 (upcoming) |
| DL40300 | Peripheral Nerve Blocks and Procedures for Chronic Pain | L40300 | Sep 10, 2026 | Oct 25, 2026 (upcoming) |
| DL40267 | Peripheral Nerve Blocks and Procedures for Chronic Pain | L40267 | Sep 10, 2026 | Oct 25, 2026 (upcoming) |
| DL40263 | Peripheral Nerve Blocks and Procedures for Chronic Pain | L40263 | Sep 10, 2026 | Oct 25, 2026 (upcoming) |
| DL40261 | Peripheral Nerve Blocks and Procedures for Chronic Pain | L40261 | Sep 10, 2026 | Oct 25, 2026 (upcoming) |
| DL33622 | Pain Management - Injection of tendon sheaths, ligaments, bursa, and ganglion cysts | L33622 | Sep 10, 2026 | Oct 25, 2026 (upcoming) |
| DL40278 | MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer | L40278 | Aug 27, 2026 | Oct 12, 2026 |
| DL40274 | MolDX: Genetic Testing for Hereditary Thrombophilia | L40274 | Aug 27, 2026 | Oct 12, 2026 |
| DL40259 | MolDX: Genetic Testing for Hereditary Thrombophilia | L40259 | Aug 27, 2026 | Oct 12, 2026 |
| DL40242 | MolDX: Genetic Testing for Hereditary Thrombophilia | L40242 | Aug 27, 2026 | Oct 12, 2026 |
| DL40238 | MolDX: Genetic Testing for Hereditary Thrombophilia | L40238 | Aug 27, 2026 | Oct 12, 2026 |
| DL40226 | MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer | L40226 | Aug 27, 2026 | Oct 12, 2026 |
| DL40222 | MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer | L40222 | Aug 27, 2026 | Oct 12, 2026 |
| DL40210 | MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer | L40210 | Aug 27, 2026 | Oct 12, 2026 |
| DL40326 | Allergy Diagnostic Testing | L40326 | Aug 20, 2026 | Oct 4, 2026 |
| DL34356 | Erythropoiesis Stimulating Agents (ESA) | L34356 | Aug 20, 2026 | Oct 4, 2026 |
| DL40341 | Allergy Diagnostic Testing | L40341 | Aug 13, 2026 | Sep 27, 2026 |
| DL40330 | Allergy Diagnostic Testing | L40330 | Aug 13, 2026 | Sep 27, 2026 |
| DL40328 | Allergy Diagnostic Testing | L40328 | Aug 13, 2026 | Sep 27, 2026 |
| DL40324 | Allergy Diagnostic Testing | L40324 | Aug 13, 2026 | Sep 27, 2026 |
| DL35010 | Trigger Point Injections | L35010 | Jul 23, 2026 | Sep 6, 2026 |
| DL33912 | Trigger Point Injections | L33912 | Jul 23, 2026 | Sep 6, 2026 |
| DL40249 | MolDX: Molecular Testing for Solid Organ Allograft Rejection | L40249 | Jul 16, 2026 | Aug 30, 2026 |
| DL40140 | MolDX: Molecular Testing for Solid Organ Allograft Rejection | L40140 | Jul 16, 2026 | Aug 30, 2026 |
| DL40062 | MolDX: Molecular Testing for Solid Organ Allograft Rejection | L40062 | Jul 16, 2026 | Aug 30, 2026 |
| DL40060 | MolDX: Molecular Testing for Solid Organ Allograft Rejection | L40060 | Jul 16, 2026 | Aug 30, 2026 |
| DL40058 | MolDX: Molecular Testing for Solid Organ Allograft Rejection | L40058 | Jul 16, 2026 | Aug 30, 2026 |
| DL40272 | MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis | L40272 | Jun 25, 2026 | Aug 10, 2026 |
| DL40199 | MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis | L40199 | Jun 25, 2026 | Aug 10, 2026 |
| DL40197 | MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis | L40197 | Jun 25, 2026 | Aug 10, 2026 |
| DL40187 | MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis | L40187 | Jun 25, 2026 | Aug 10, 2026 |
| DL33398 | Transcranial Magnetic Stimulation | L33398 | Jun 25, 2026 | Aug 9, 2026 |
| DL40334 | Erythropoiesis Stimulating Agents | L40334 | May 28, 2026 | Jul 15, 2026 |
| DL40302 | Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain | L40302 | May 28, 2026 | Jul 15, 2026 |
| DL35000 | Molecular Pathology Procedures | L35000 | May 28, 2026 | Jul 15, 2026 |
| DL40205 | Irreversible Electroporation for Cancer | L40205 | May 21, 2026 | Jul 5, 2026 |
| DL40257 | Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices | L40257 | May 14, 2026 | Jun 28, 2026 |
| DL40244 | Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices | L40244 | May 14, 2026 | Jun 28, 2026 |
| DL40255 | Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices | L40255 | May 7, 2026 | Jun 21, 2026 |
DL37421 would have revised L37421, which retired August 1, 2026; DL38707 would have revised L38707, which retired March 5, 2026. With the policy gone the proposal can no longer take effect, so it is left out as well.
How this tracker is built
The list is computed from the LCD table of the weekly Medicare Coverage Database export, where a proposal carries status P, its comment start and end dates, its contractors and the number the final policy will use: its own reserved number for a new policy, or the number of the active LCD it would revise. A proposal counts as finalised when an LCD with its number is now final and, for a revision, was posted for notice on or after the comment period closed, or when a final LCD posted after the comment period lists the proposal among its related documents. The states come from the contractors' current jurisdictions, and each proposal's issue statement is quoted from the database as the contractor wrote it, with any licensed CPT descriptor text removed.
The export is rebuilt every week after the Thursday release, and the open or closed status above is worked out against today's date, so a deadline that passes between two releases is shown as closed. Each active LCD with a pending revision, and each topic page with pending proposals, carries a notice that links back here. For the policies already in force, start from the LCD hub or the guide to finding the LCD for a state; the Medicare Coverage Database guide explains the document types and IDs.
For teams evaluating QuickIntell software
Where QuickIntell fits with this policy
If your team repeatedly reviews local coverage policies, explore QuickAuth for requirement checks, documentation and status tracking with staff oversight. Confirm the applicable policy, supported workflow and review responsibilities. Use QuickRCM to evaluate the separate claim and denial workflow.
Optional software evaluation, not payer support or help with an individual claim. For coverage or payment decisions, use the official sources on this page. Do not include patient information in a demo booking or inquiry.
Frequently asked questions
How long is the comment period for a proposed LCD?
At least 45 calendar days from the day the proposed LCD is published on the Medicare Coverage Database. The Program Integrity Manual (Pub. 100-08, chapter 13, section 13.2.4.2) sets that minimum and has the contractor contact CMS when it needs to extend it. The comment end date in each row here is the date the contractor recorded in the database.
When does a proposed LCD take effect?
Not while it is a proposal. After the comment period and the open meeting, the contractor publishes the final LCD together with a Response to Comments article, and that publication starts a notice period of at least 45 calendar days. Unless the notice period is extended, the LCD takes effect on the 46th day after it began (chapter 13, sections 13.2.5 and 13.2.6).
What happens to a proposed LCD that is never finalized?
Chapter 13, section 13.5.6 requires contractors to finalize or retire every proposed LCD within a rolling year (365 days) of its publication date on the database; a contractor that needs longer asks CMS for an exception. This page flags pending proposals whose year has passed, because the database still lists them.
Does a pending proposal change how my claims are paid now?
No. Claims are judged against the LCD in force on the date of service. A proposed revision shows where the contractor intends to go, so it is worth reading before it takes effect, but the current policy and its billing and coding article keep governing until the final version's effective date.
How do I comment on a proposed LCD?
In writing to the contractor that published it, before the comment end date. The proposed LCD record on cms.gov names the contact for comments, and the contractor announces its open meeting, where interested parties can present; the manual notes that all formal comments must still be submitted in writing (chapter 13, section 13.2.4.4).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
- Medicare Program Integrity Manual (Pub. 100-08)Version 15 chapter PDFs; newest revision Rev. 13890 (chapter 12), issued 2026-07-30 · effective 2026-09-27 · file 100-08-program-integrity-manual/*.pdf (15 chapters; SHA-256 of their sha256sum listing)SHA-256 efb2c5dd5abb3fe4…
Disclaimer
Proposal dates, contractors and issue statements are reproduced from the CMS Medicare Coverage Database export as an operational reference. A proposed LCD is not in effect; verify deadlines and comment instructions in the record on cms.gov before relying on them. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.