Medicare local coverage
Medicare coverage for MolDX: Molecular Diagnostic Tests (MDT) (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Molecular Diagnostic Tests (MDT). The snapshot lists 5 LCD records: 4 active, 1 retired.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L36021 | Active | Aug 15, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36256 | Retired Feb 5, 2026 | Feb 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L35160 | Active | Jan 26, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L35025 | Active | Aug 26, 2024 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L36807 | Active | May 20, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A56853Palmetto GBAUpdated Jul 21, 2026
- A56973CGS Administrators, LLCUpdated Jul 24, 2026
- A57526Noridian Healthcare Solutions, LLCUpdated Jul 21, 2026
- A57527Noridian Healthcare Solutions, LLCUpdated Feb 5, 2026
- A57772WPS Insurance CorporationUpdated Jul 24, 2026
CMS also lists 4 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A54547, A54552, A54553, A54554.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Allergy Diagnostic Testing
- Colonoscopy and Sigmoidoscopy-Diagnostic
- Diagnostic Abdominal Aortography and Renal Angiography
- Diagnostic and Therapeutic Colonoscopy
- Diagnostic and Therapeutic Esophagogastroduodenoscopy
- Diagnostic Colonoscopy
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.