Medicare Part B Clinical Coverage & Evidence Resources

This resource center provides Medicare coverage information, CMS National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and evidence-based clinical guidance documents related to select Part B therapies.

As part of our medical benefit management approach, we maintain disease-specific clinical guidance documents designed to promote evidence-based therapy utilization, alignment with FDA-approved indications, consideration of current clinical literature, and consistency with applicable Medicare coverage requirements. The information presented is intended to support providers in understanding applicable Medicare coverage requirements, current clinical evidence, FDA-approved labeling, and appropriate patient selection considerations.

For Medicare Fee-for-Service beneficiaries, coverage and payment determinations remain governed by applicable CMS requirements, including relevant LCDs and NCDs where applicable.

Clinical Guidance Documents

These documents summarize clinical evidence, FDA labeling, professional society recommendations, and common patient selection considerations associated with therapy use. They are intended to support clinical decision-making and care management activities.