• 2025 Medicare Basic - No Rx (HMO)
  
  • Annual Notice of Change
    
  • Evidence of Coverage
    
• 2025 Medicare Value (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
    
• 2025 Medicare Plus (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
    
• 2025 Medicare Premium (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
    
• 2025 Medicare Premium - No Rx (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
    
• 2025 Medicare Compass (PPO)
  • Annual Notice of Change
  • Evidence of Coverage

• 2024 Baystate Health Preferred (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Basic - No Rx (HMO)
  
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Value (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Plus (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Premium (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Premium - No Rx (HMO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Compass (PPO)
  • Annual Notice of Change
  • Evidence of Coverage
• 2024 Medicare Compass Premier (PPO)
  • Annual Notice of Change
  • Evidence of Coverage

Effective July 1, 2015, in Accordance with the Achieving a Better Life Experience Act of 2014 Section 203 of the Achieving a Better Life Experience (ABLE) Act of 2014 implements changes to treat VES prosthetic devices and related accessories as statutorily noncovered in the same manner that erectile dysfunction drugs are treated in Part D.

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Effective Sept. 27, 2021: CMS is finalizing changes to two separate, but medically related, NCDs. Given new information in the peer-reviewed medical literature, CMS is removing the NCD for Home Oxygen Use to Treat Cluster Headache (CH) (240.2.2), and is also revising the NCD for Home Use of Oxygen (240.2).

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Effective Feb. 10, 2022: CMS reconsidered the NCD established at section 210.14 of the Medicare NCD manual and has determined that the evidence is sufficient to expand the eligibility criteria for Medicare beneficiaries receiving low dose computed tomography (LDCT) when certain criteria are met.

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Effective January 19, 2021, The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover a blood-based biomarker test as an appropriate colorectal cancer screening test once every 3 years for Medicare beneficiaries when performed in a Clinical Laboratory Improvement Act (CLIA)-certified laboratory, when ordered by a treating physician.

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Effective April 13, 2015, Medicare will cover annual voluntary HIV screening for all beneficiaries age 15 to 65, and for beneficiaries younger than 15 and older than 65 who are at increased risk for HIV infection. Medicare will cover a maximum of 3 voluntary screenings for pregnant beneficiaries under certain conditions.

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Effective July 9, 2015, Medicare has determined that the evidence is sufficient to add Human Papillomavirus (HPV) testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test. CMS will cover screening for cervical cancer with the appropriate U.S. Food and Drug Administration (FDA) approved/cleared laboratory tests, used consistent with FDA approved labeling and in compliance with the Clinical Laboratory Improvement Act (CLIA) regulations.

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Effective October 3, 2016, The Centers for Medicare & Medicaid Services (CMS) covers percutaneous LAAC for non-valvular atrial fibrillation (NVAF) through Coverage with Evidence Development (CED) under 1862(a)(1)(E) of the Social Security Act with certain conditions.

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Effective May 25, 2017 the Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover supervised exercise therapy (SET) for beneficiaries with intermittent claudication (IC) for the treatment of symptomatic peripheral artery disease (PAD). Up to 36 sessions over a 12 week period are covered if all of the components of a SET program are met.

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Effective January 18, 2017, the Centers for Medicare & Medicaid Services (CMS) covers leadless pacemakers through Coverage with Evidence Development (CED). CMS covers leadless pacemakers when procedures are performed in Food and Drug Administration (FDA) approved studies. CMS also covers, in prospective longitudinal studies, leadless pacemakers that are used in accordance with the FDA approved label for devices that have either an associated ongoing FDA approved post-approval study or completed an FDA post-approval study.

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Effective August 7, 2019, A.The Centers for Medicare & Medicaid Services (CMS) covers autologous treatment for cancer with T-cells expressing at least one chimeric antigen receptor (CAR) when administered at healthcare facilities enrolled in the FDA risk evaluation and mitigation strategies (REMS) and used for a medically accepted indication as defined at Social Security Act section 1861(t)(2) i.e., is used for either an FDA-approved indication (according to the FDA-approved label for that product), or for other uses when the product has been FDA-approved and the use is supported in one or more CMS-approved compendia.

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Effective July 2, 2019, The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries under the following circumstances:

1. For beneficiaries with suspected white coat hypertension, which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm Hg but less than 160 mm Hg or diastolic blood pressure greater than 80 mm Hg but less than 100 mm Hg on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are <130/80 mm Hg.

2. For beneficiaries with suspected masked hypertension, which is defined as average office blood pressure between 120 mm Hg and 129 mm Hg for systolic blood pressure or between 75 mm Hg and 79 mm Hg for diastolic blood pressure on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are ≥130/80 mm Hg.

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Effective January 21, 2020, The Centers for Medicare & Medicaid Services (CMS) will cover acupuncture for chronic low back pain under section 1862(a)(1)(A) of the Social Security Act. Up to 12 visits in 90 days are covered for Medicare beneficiaries under the following circumstances.

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Effective January 27, 2020, The Centers for Medicare & Medicaid Services (CMS) has determined that Next Generation Sequencing (NGS) as a diagnostic laboratory test is reasonable and necessary and covered nationally, when performed in a CLIA-certified laboratory, when ordered by a treating physician and when certain requirements are met.

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Effective January 19, 2021, for clarity, the term Transcatheter Mitral Valve Repair (TMVR) is being replaced with mitral valve Transcatheter Edge-to-Edge Repair (TEER) to more precisely define the treatment addressed in this proposed NCD, which is applicable to TEER for the treatment of functional mitral regurgitation (MR) and degenerative MR.

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