CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.1 Reasonable and Necessary Provisions in LCDs Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Medicare does not cover items and services that are not reasonable and necessary for the diagnosis or treatment of CMS Program Integrity Manual, Section 13.5.1, in order to be covered under Medicare, a service shall be reasonable and necessary. Drugs and biologicals must be determined to meet the statutory definition under the statute §1861(t) (1). Medicare Benefit Policy Manual - Pub. 100-02, Chapter 15, Section 50 CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.4 Reasonable and Necessary Provisions in LCDs Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Medicare does not cover items and services that are not reasonable and necessary for the diagnosis or treatment of CMS Program Integrity Manual, Section 13.5.1, in order to be covered under Medicare, a service shall be reasonable and necessary. Drugs and biologicals must be determined to meet the statutory definition under the statute §1861(t) (1). Medicare Benefit Policy Manual -Pub. 100-02, Chapter 15, Section 50 CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4. Reasonable and Necessary Provisions in LCDs. CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 6, Section 6.5.3. CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.1 Reasonable and Necessary Provisions in LCDs Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Medicare does not cover items and services that are not reasonable and necessary for the diagnosis or treatment of an illness or Medicare Benefit Policy Manual- Pub. 100-02, Chapter 15, Section 50, describes national policy regarding Medicare guidelines Medicare Program Integrity Manual, Chapter 13 Local Coverage Determinations; § 13.5.1 Reasonable and Necessary Provisions in LCDs NCCN Drugs & Biologics Compendium, National Comprehensive Cancer Network Website Medicare Benefit Policy Manual (MBPM), Pub. No. 100-02, Chapter 15, Covered Medical and Other Health Services; Section 80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests. MBPM, Pub. No. 100-02, Chapter 16, General Exclusions from Coverage and Section 20, Services Not Reasonable and Necessary. As published in the CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4, an item or service may be covered by a contractor LCD if it is reasonable and necessary under the Social Security Act Section 1862 (a)(1)(A). Contractors shall determine and describe the circumstances under which the item or service CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4. Reasonable and Necessary Provisions in LCDs Local Coverage Determination (LCD) L33274. Botulinum Toxins. Effective October 1, 2015-present LCD L33646. Botulinum Toxins. Effective October 1, 2015-present LCD L33949. Botulinum Toxins. CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 13