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License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA websiteExternal Website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

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  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association websiteExternal Website.
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February 25, 2021

Proposed Local Coverage Determinations (LCDs) Released for Comment – Enteral Nutrition, Oral Appliances for Obstructive Sleep Apnea, Parenteral Nutrition, Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea, and Respiratory Assist Devices

The Centers for Medicare and Medicaid Services (CMS) assigned to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) the task of developing LCDs for Durable Medical Equipment, Prostheses, Orthoses, and Supplies (DMEPOS). The DME MACs are proposing five LCDs as described below:

  1. Enteral Nutrition (DL38955) – Proposed LCD for enteral nutrition.
  2. Oral Appliances for Obstructive Sleep Apnea (DL33611) – Removed language related to home sleep testing devices. The DME MAC LCD will defer to the CMS NCD 240.4.1 and the A/B MAC.
  3. Parenteral Nutrition (DL38953) – Proposed LCD for parenteral nutrition.
  4. Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (DL33718) – Removed language related to home sleep testing devices. The DME MAC LCD will defer to the CMS NCD 240.4.1 and the A/B MAC.
  5. Respiratory Assist Devices (DL33800) – Removed language related to home sleep testing devices. The DME MAC LCD will defer to the CMS NCD 240.4.1 and the A/B MAC.

Stakeholders may read the details of the proposed LCDs posted on the Medicare Coverage Database by referencing the LCD ID number in the search field. The entire proposed LCD should be completely reviewed prior to the submission of written comments.

We are soliciting comments on these proposed LCDs from clinicians, manufacturers, suppliers, and other stakeholders who care for Medicare beneficiaries. You should be very specific in your comments, and if possible, offer suggestions that may address your concerns. You should provide an evidence-based rationale for your comments, and attach any full-text references from the published clinical literature (e.g. peer-reviewed journals, clinical society guidelines, etc.) that were not included in the bibliography of the proposed LCDs. We encourage a written response regardless of your agreement or disagreement with the proposed LCDs.

All comments will be collected at a single point of contact for each proposed LCD. Comments that address more than one proposed LCD should be submitted to each LCD email address for which comments are being made. Do not include any protected health information (PHI) or personally identifiable information (PII). Please submit your comments electronically to the DME MACs at the email addresses below no later than Saturday, April 10, 2021 at 5 pm ET.

Enteral Nutrition (DL38955): ENTLCDComments@cgsadmin.com

Oral Appliances for Obstructive Sleep Apnea (DL33611): OAOSARecon@noridian.com

Parenteral Nutrition (DL38953): PENRecon@noridian.com

Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (DL33718): PAPLCDComments@cgsadmin.com

Respiratory Assist Devices (DL33800): RADRecon@noridian.com

Suppliers and clinicians are cautioned not to make any changes based upon the information contained in a proposed LCD, as the revisions posed in a proposed LCD may be further revised or otherwise updated based upon the comments received. When all comments have been reviewed, revisions will be considered. A “Response to Comments” document will be published with the final LCDs. The final LCDs will be published in the CMS Medicare Coverage Database and accessible on individual DME MAC websites, allowing for a minimum 45-day notice period before the final LCDs are effective.

*IMPORTANT: The DME MACs will host open meetings to further solicit input from stakeholders for each of the proposed LCDs. These meetings will take place on March 30, 2021. For details regarding participation in the open meetings, refer to the Open Meeting Announcement articles posted at https://www.cgsmedicare.com/jc/coverage/tracking.html.

Refer to each DME MAC web site for additional information, including access to the proposed LCDs.

Thank you for your participation in our policy development process.

Smitha M. Ballyamanda, MD, CAQSM
Medical Director, DME MAC Jurisdiction A
Noridian Healthcare Solutions, LLC

Stacey V. Brennan, MD, FAAFP
Medical Director, DME MAC Jurisdiction B
CGS Administrators, LLC

Robert D. Hoover, Jr., MD, MPH, FACP
Medical Director, DME MAC Jurisdiction C
CGS Administrators, LLC

Peter J. Gurk, MD, CPE, CHCQM
Medical Director, DME MAC, Jurisdiction D
Noridian Healthcare Solutions, LLC

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