Decision by a Medicare fiscal intermediary whether to cover a particular service on an intermediary-wide or carrier-wide basis in accordance with the Social Security Act. This determination is based on whether the service is considered reasonable and necessary. The difference between local medical review policies (LMRPs) is that LCDs consist of only “reasonable and necessary” information, whereas LMRPs may also contain cate- gory or statutory provisions. Formerly known as local medical review policy (LMRP) .