Which Medicare contractor covers my state?

Medicare uses 12 Part A/B jurisdictions, each run by one Medicare Administrative Contractor (MAC). The contractor for your state processes your Medicare claims and publishes the local coverage policies (LCDs) that decide which diagnoses support each procedure in your region.

So the same claim can pass in one state and be denied in another. Knowing your contractor is the first step in preventing CO-50 and CO-11 denials.

• Durable medical equipment and home health have their own contractors, separate from the Part A/B contractors above.
• Contracts are re-awarded from time to time, which can move a jurisdiction to a different company. Confirm on cms.gov before relying on it.
• Commercial payers follow their own medical policies, though some follow Medicare's.

A local coverage policy only binds its own jurisdiction. A finding that cites another region's policy is wrong, and a biller who checks it will stop trusting the next one.

This page is general information, not legal or billing advice.