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LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2025
2024
QW Tests

Physician Fee Schedule

2025
2024

OPPS Fee Schedule

2025-January
2024-October

ASC Fee Schedule

2025-January
2024-October

APC Codes

2025-January
2024-October

DRG Codes

2025
2024

ASP Drug Pricing Files

2025-January
2024-October


CMS Transmittals



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Medical Necessity Compliance

CMS states that in FY2003 5.8% of submitted claims resulted in improper overpayments totaling more than $11.6 billion. A majority of these overpayments are the result of medically unnecessary testing and procedures and improper coding practices.

Every Medicare provider struggles to comply with Medical Necessity Policies such as National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).

CodeMap Has A Solution: CodeMap Data Files

CodeMap maintains the most comprehensive database of Medicare coverage policy concerning laboratory and pathology procedures. Our database contains accurate and up-to-date information from NCDs as well as LCDs, formerly known as LMRPs. All NCD information comes directly from CMS program memorandum, transmittals and other communications. All LCD information contained in our database is derived directly from Medicare Carrier bulletins, LCD advisory meetings, and oth....

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