# 42 CFR § 426.325: What may be challenged

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-42-426.325

## Section

- **Citation:** 42 CFR § 426.325
- **Heading:** What may be challenged
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM > PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS > Subpart C—General Provisions for the Review of LCDs and NCDs

## Text

(a) Only LCDs or NCDs (including deemed NCDs) that are currently effective may be challenged.
(b) Some items are not reviewable under this part, including the following:
(1) Pre-decisional materials, including—
(i) Draft LCDs;
(ii) Template LCDs or suggested LCDs; and
(iii) Draft NCDs, including national coverage decision memoranda.
(2) Retired LCDs or withdrawn NCDs.
(3) LCD or NCD provisions that are no longer in effect due to revisions or reconsiderations.
(4) Interpretive policies that are not an LCD or NCD.
(5) Contractor decisions that are not based on section 1862(a)(1)(A) of the Act.
(6) Contractor claims processing edits.
(7) Payment amounts or methodologies.
(8) Procedure coding issues, including determinations, methodologies, definitions, or provisions.
(9) Contractor bulletin articles, educational materials, or Web site frequently asked questions.
(10) Any M + C organization or managed care plan policy, rule, or procedure.
(11) An individual claim determination.
(12) Any other policy that is not an LCD or an NCD as set forth in § 400.202 of this chapter.

## Nearby sections

- [42 CFR § 426.100 § 426.100 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.100.md)
- [42 CFR § 426.110 § 426.110 Definitions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.110.md)
- [42 CFR § 426.120 § 426.120 Calculation of deadlines.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.120.md)
- [42 CFR § 426.130 § 426.130 Party submissions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.130.md)
- [42 CFR § 426.300 § 426.300 Review of LCDs, NCDs, and deemed NCDs.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.300.md)
- [42 CFR § 426.310 § 426.310 LCD and NCD reviews and individual claim appeals.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.310.md)
- [42 CFR § 426.320 § 426.320 Who may challenge an LCD or NCD.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.320.md)
- [42 CFR § 426.325 § 426.325 What may be challenged.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.325.md)
- [42 CFR § 426.330 § 426.330 Burden of proof.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.330.md)
- [42 CFR § 426.340 § 426.340 Procedures for review of new evidence.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.340.md)
- [42 CFR § 426.400 § 426.400 Procedure for filing an acceptable complaint concerning a provision (or provisions) of an LCD.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.400.md)
- [42 CFR § 426.403 § 426.403 Submitting new evidence once an acceptable complaint is filed.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.403.md)
- [42 CFR § 426.405 § 426.405 Authority of the ALJ.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.405.md)
- [42 CFR § 426.406 § 426.406 Ex parte contacts.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.406.md)

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-42-426.325. Check the current official text before relying on it. Not legal advice.