Medicare local coverage
Medicare coverage for Prostate Cancer Detection with IsoPSA® (LCD)
One Medicare Administrative Contractor, CGS Administrators, LLC, publishes a local coverage determination (LCD) for Prostate Cancer Detection with IsoPSA®. The snapshot lists 1 LCD record: 1 active.
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 | L39284 | Active | Oct 31, 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.
- A59066CGS Administrators, LLCUpdated Oct 31, 2025
CMS also lists 1 response-to-comments article for this topic, where contractors answer public comments on the proposed LCD: A59242.
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: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
- Automated Detection and Quantification of Brain MRIs
- Cardiac Event Detection
- Irreversible Electroporation for Cancer
- Laser Ablation of the Prostate
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.