The Centers for Medicare and Medicaid (CMS) have a number of vehicles for communicating and receiving feedback on coverage policies to ensure appropriate coverage and coding of radiation therapy services.
CMS provides coverage for items and services based on policies primarily developed on a local level, called local coverage determinations (LCDs). These policies are developed by contractors that pay Medicare claims, however in certain cases CMS deems it appropriate to develop a national coverage determination (NCD) for an item or service which is then applied on a national basis for all Medicare beneficiaries meeting the criteria for coverage. CMS also utilizes the Medicare Evidence Development and Coverage Advisory Committee (MedCAC) in making coverage determinations.
ASTRO closely follows these policies and submits letters in response to draft LCDs, NCDs and coding issues published by CMS, advocating for appropriate coverage and payment for radiation therapy services.
Comment letters submitted in response to CMS coverage determinations.