Each third-party health payer has its own method of determining which medical services should be covered. The new National Center for Health Care Technology (NCHCT) is charged with evaluating the medical and scientific basis for Medicare coverage of various tests and procedures used in the practice of medicine. Many of the important issues involved in performing these evaluations and the NCHCT approach are described in this article.
Towery OB, Perry S. The Scientific Basis for Coverage Decisions by Third-Party Payers. JAMA. 1981;245(1):59-61. doi:10.1001/jama.1981.03310260037025