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Medicare Coverage Policies

For Questions regarding reimbursement related to Apligraf® please call the Reimbursement Support Center (1-888-Heal-2-DAY), Option 3.



Click the state on the map to find state specific coding and coverage guidelines where it is available. Select Medicare LCD Summary Part A or Medicare LCD Summary Part B.

  • For facilities billing Wisconsin Physician Services, Formerly Mutual of Omaha click here
Medicare LCD Map Washington Oregon California Idaho Montana Nevada Arizona Alaska Utah Hawaii Wyoming Colorado New Mexico North Dakota South Dakota Nebraska Kansas Oklahoma Texas Virgin Islands Minnesota Iowa Missouri Arkansas Louisiana Wisconsin Illinois Michigan Michigan Indiana Kentucky Ohio Tennessee Mississippi Alabama Florida Georgia South Carolina North Carolina West Virginia Virginia District of Columbia Maryland Delaware New Jersey Connecticut Connecticut Pennsylvania New Jersey New York Vermont New Hampshire Vermont New Hampshire Maine Massachusetts Rhode Island Massachusetts Maryland Puerto Rico

Alabama

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

Alaska

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Arizona

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Arkansas

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

California

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Colorado

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Connecticut

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Delaware

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

District of Columbia

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Florida

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  First Coast
  First Coast

 

 

Georgia

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

Hawaii

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Idaho

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Illinois

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Indiana

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Iowa

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Kansas

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Kentucky

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Cigna MAC
  Cigna MAC

 

 

Louisiana

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Maine

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Maryland

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Massachusetts

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Michigan

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Minnesota

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Mississippi

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Missouri

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Montana

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Nebraska

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Wisconsin Physician Services
  Wisconsin Physician Services

 

 

Nevada

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

New Hampshire

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

New Jersey

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

New Mexico

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

New York

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

North Carolina

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

North Dakota

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Ohio

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Cigna MAC
  Cigna MAC

 

 

Oklahoma

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Oregon

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Pennsylvania

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Puerto Rico

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  First Coast
  First Coast

 

 

Rhode Island

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

South Carolina

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

South Dakota

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Tennessee

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

Texas

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Novitas
  Novitas

 

 

Utah

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

Vermont

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Virginia

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

Virgin Islands

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  First Coast
  First Coast

 

 

Washington

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 

 

West Virginia

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Palmetto
  Palmetto

 

 

Wisconsin

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  National Government Services
  National Government Services

 

 

Wyoming

Part A LCD for Apligraf
 
Part B LCD for Apligraf
   
   
  Noridian
  Noridian

 


1American Medical Association, CPT Changes 2007-An Insider’s View, pg. 27

Disclaimer: The information provided on this website is informational only. This is not a guarantee of Reimbursement Rates, nor is it intended to make recommendations regarding clinical practices. Information on this website is subject to change with out notice due to changes in reimbursement laws, regulations, rules and policies. The ultimate responsibility for correct coding lies with the provider of services. Please contact the appropriate payer for their interpretation of the appropriate code to use for the procedure.