Last Modified: 5/21/2020
Location: FL, PR, USVI
Business: Part A, Part B
The Centers for Medicare & Medicaid Services (CMS) instructions regarding development of local coverage determinations (LCDs) are outlined in the CMS internet-only manual (IOM) publication 100-08, Medicare program integrity manual (PIM), chapter 13, section 13.2. Local coverage determinations (LCDs) are a determination of whether or not a service or item is considered to be eligible for coverage on a contractor wide basis in accordance with section 1862(a)(1)(A) of the Social Security Act (SSA); that is, the service is considered to be “reasonable and necessary”. LCDs must be consistent with all statutes, rulings, regulations, national coverage, payment and coding policies.
Detailed instructions regarding the LCD development process are found in the CMS IOM, publication 100-08, PIM, chapter 13. The process includes consultations with experts, publication of the proposed policy, opportunity for public comments in writing, publication of a final LCD, response to public comments and notice of the new policy.
First Coast Service Options publishes LCDs on the
CMS Medicare coverage database (MCD)
, to provide guidance to the public and medical community within our geographic jurisdictions. A listing of the LCDs with links to the policies can be found on the First Coast website at
First Coast LCDs.
First Coast provides a 45 day comment period for each proposed LCD. This comment period is scheduled to include time before and after the open meeting. The proposed LCDs, the proposed status page, and information about how to submit comments are provided on the website at: Submission of comments for proposed LCDs.
Please direct all written comments to First Coast via email at
medical.policy@fcso.com, or by Faxination 1-904-361-0422, or by mail to:
First Coast Service Options
PO Box 45274
Jacksonville, FL 32232-5274
or
First Coast Service Options
Attn: Medical Policy and Procedures
532 Riverside Ave
Jacksonville, FL 32202-4914
For questions regarding local coverage determinations, please call the provider contact Center at:
Medicare Part A 888-864-4112
Medicare Part B 866-454-9007
Note, however, that all comments on proposed LCDs must be submitted to the Medical Policy and Procedures department in writing at the above indicated address.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
