Medical Necessity

The Centers for Medicare and Medicaid Services (CMS) provide coverage that is limited to services deemed reasonable and necessary for the diagnosis or treatment of an illness or injury, and within the scope of a Medicare benefit category. CMS has developed a library of Local Coverage Determination (LCD) and National Coverage Determination (NCD) policies, many of which are applicable to tests and procedures performed by Fulgent or one of our subsidiaries. Each policy, including any corresponding Article, provides the required indications and limitations of coverage, and typically a list of diagnoses that support medical necessity.

As a service to our clients and treating physicians, we have provided links to specific tests and procedures performed by Fulgent labs as well as a link to instructions for the aforementioned policies.