March 6, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down the complex “alphabet soup” of Medicare coverage and auditing tools—including NCDs, LCDs, LCAs, RAC audits, and the emerging WISER program—and explain how they work together to shape reimbursement policy. Prompted by a new multi-state LCD affecting Botox coverage, the discussion walks through how coverage determinations are created, how Medicare contractors enforce them, and why documentation requirements continue to expand. The panel also explores how practices can adapt by building workflows, intake forms, and clinical documentation processes that capture the data Medicare expects—helping physicians navigate audits while still delivering appropriate patient care.

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UCR 279: LCDs, NCDs, LCAs, and Audits — Understanding Medicare’s Coverage Landscape