Posted On February 19, 2026
Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Article (PA) that have been revised and posted. The policy included is Nebulizers. Please review the entire LCD and PA for complete information.

Nebulizers

LCD

Revision Effective Date: 02/01/2026
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Revised: "The following table represents the maximum milligrams/per month of inhalation drugs that are reasonable and necessary for each nebulizer drug." to "The following table represents the maximum per month of inhalation drugs that are reasonable and necessary for each nebulizer drug.," as clarification
Revised: "Maximum Milligrams/Month" to "Maximum Per Month" in the header of the second column within the tables that pertain to the maximums per month of inhalation drugs and solutions, as clarification
Revised: "When albuterol, levalbuterol, or metaproterenol are prescribed as rescue/supplemental medication for beneficiaries who are taking formoterol or arformoterol, the maximum milligrams/per month that are reasonably billed are:" to "When albuterol, levalbuterol, or metaproterenol are prescribed as rescue/supplemental medication for beneficiaries who are taking formoterol or arformoterol, the maximum per month that are reasonably billed are:," as clarification
Revised: "Albuterol/Ipratroprium combination" to "Albuterol/Ipratropium combination" in the first column of the second table pertaining to inhalation drugs and solutions

02/19/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary.

PA

Revision Effective Date: 02/01/2026
CODING GUIDELINES:
Added: Long description for J7699
Removed: Billing information for claims with dates of service from January 1, 2008 through March 31, 2008 pertaining to J7602 and J7603, due to timely filing limit
Revised: "Suppliers must be sure that they use the correct billing unit or the code when calculating the number of units of service to enter on the claim." to "Suppliers must be sure that they use the correct billing unit of the code when calculating the number of units of service to enter on the claim."
Revised: Billing unit of service language regarding J7626 for a 0.25 mg vial and a 0.5 mg vial, as clarification
Added: Billing unit of service information regarding J7626 for a 1 mg vial, as clarification
Removed: J7627 from the billing unit of service information (budesonide, unit dose), due to non-coverage of compounded solutions
Removed: Billing information for claims with dates of service on or after November 9, 2018, through June 30, 2019 pertaining to revefenacin, due to timely filing limit

02/19/2026: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Note: The information contained in this article is only a summary of revisions to the LCDs and/or PAs. For complete information on any topic, you must review the LCDs and/or PAs.

With the update(s) listed above, Noridian would like to remind users how to find the policy that was previously effective. When billing, the supplier should follow guidance that was effective on the date of service. The below steps can be followed to find all previous policies:

1. Open the currently effective policy on the Medical Coverage Database (MCD)
   1. Links to the MCD can be found on the Active LCDs page on the Noridian website
      1. There is a link at the top of the Active LCD page that goes to a full list of the LCDs or PAs, depending on which link is selected OR
      2. There are direct links to all LCDs under the ‘LCD ID number and Effective Date’ column
2. Scroll down to the bottom of the policy
3. Find the section labeled Public Version(s)
4. Look for the link to the policy that was effective on the dates of service in question.
5. Click on hyperlink to go to the policy.