Definitions

80.1 - Definitions (Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05) (Chapter 4, §90 of the Medicare Managed Care Manual) A National Coverage determination (NCD) is a determination by CMS about whether or not a particular item or service is covered nationally under Medicare. A Medicare cost plan must comply with all NCDs. A legislative change in benefits refers to new Medicare coverage of an item or service mandated by the Congress.