National Coverage Determination - The NCD Decision Process

The NCD Decision Process

The NCD development process generally takes 6–9 months, depending on the need for external technology assessments or coverage advisory committee reviews. For NCD requests that do not require these assessments/reviews, the entire NCD decision will be made no more than 6 months after the date the request is received.
Phases during the first 6 months:

  • Preliminary Discussions
  • Benefit Category
  • National Coverage Request
  • Staff Review
  • External Technology Assessment and/or Medicare Coverage Advisory Committee
  • Staff Review
  • Draft Decision and Memorandum Posted

Phases during last 3 months

  • Public Comments (30 days)
  • Final Decision Memorandum and Implementation Instructions (must be completed in 60 days)

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