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November 5, 2026

External Breast Prostheses - Final LCD and Response to Comments (RTC) Article Published

Joint DME MAC Publication

On November 5, 2026, the DME MACs published the following final Local Coverage Determination (LCD) and LCD-related Policy Article (PA):

  • External Breast Prostheses LCD (L33317) and LCD-related PA (A52478)

The LCD incorporates finalized revisions, as a result of the LCD reconsideration process and written comments received during the comment period for the proposed LCD. The final LCD expands coverage for breast prostheses, silicone or equal, with integral adhesive.

The posting of the final LCD marks the beginning of the 45-day notice period. The final LCD goes into effect for claims with dates of service on or after December 20, 2026.

Along with the final LCD and LCD-related PA, the DME MACs published a Response to Comments (RTC) Article which addresses the written comments received during the comment period. The RTC Article is as follows:

  • Response to Comments: External Breast Prostheses – DL33317 (A60574)

Interested stakeholders may find the RTC document by searching for the article number in the Medicare Coverage DatabaseExternal Website. The RTC document is also located in the Associated Documents section of the LCD.

Please refer to each DME MAC website for additional information about policy development and access to the final LCD.

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