Medicare local coverage
Medicare coverage for ProMark® Risk Score (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for ProMark® Risk Score. 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 | L36675 | Active | Nov 5, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36706 | Retired Oct 23, 2025 | Oct 23, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36704 | Active | Oct 14, 2025 |
Palmetto GBAMAC - Part A, MAC - Part B | L36665 | Active | Dec 22, 2021 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L37011 | Active | Dec 22, 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.
- A56957Palmetto GBAUpdated Dec 22, 2021
- A57034CGS Administrators, LLCUpdated Nov 8, 2024
- A57515Noridian Healthcare Solutions, LLCUpdated Oct 14, 2025
- A57587WPS Insurance CorporationUpdated Dec 20, 2023
- A57609Noridian Healthcare Solutions, LLCUpdated Oct 23, 2025
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
- MolDX: Biomarkers in Cardiovascular Risk Assessment
- MolDX: Melanoma Risk Stratification Molecular Testing
- MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma
- MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules
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.