Reimbursement intelligence
LCD Monitoring Software across all seven MACs
CLV Intelligence is LCD monitoring software that tracks Local Coverage Determinations and Billing & Coding Articles from all seven Medicare Administrative Contractors — the contractor policies where most Medicare denials originate.
- 1,150+
- Policy alerts tracked
- 33
- Clinical specialties
- 7
- MAC contractors
- 15+
- Source families
A Local Coverage Determination (LCD) is a Medicare Administrative Contractor’s decision about when a service is covered in its jurisdiction — the medical-necessity criteria, covered diagnoses, and documentation requirements that decide whether a claim is paid. LCDs change on no fixed schedule, differ by contractor, and are where the majority of Medicare denials begin. CLV Intelligence is LCD monitoring software that watches all seven MACs every business day and flags the revisions, retirements, and new LCDs that affect the codes you bill.
Coverage
What CLV monitors across CMS
New and revised LCDs
Every LCD addition and revision across the seven MAC jurisdictions, parsed for the codes and criteria affected.
Billing & Coding Articles
The companion articles that carry the code lists and billing guidance attached to each LCD.
Retired and future LCDs
Retirements and not-yet-effective LCDs, so you see coverage changes coming before the effective date.
Notice & comment periods
Proposed LCDs and notice periods, tracked so you can respond before policy is finalized.
Medical-necessity criteria
Changes to covered diagnoses and documentation requirements — the most common cause of LCD-driven denial.
Jurisdiction mapping
Every change tied to its MAC and the states it governs, so you only act on what applies to you.
How it works
From source to action, every day
We monitor the sources
CMS, every Medicare Administrative Contractor, and the Federal Register — scanned continuously, with the originating government document linked on every alert.
AI translates the impact
Dense regulatory text is distilled into the specialties, codes, and dollar exposure that actually affect your claims, then ranked by a signal score.
You act before it bills
Severity-ranked alerts with plain-language action guidance — plus audit-ready exports — reach the right team in time to change the claim.
Why automated monitoring
Why it beats manual source-watching
Seven contractors, seven moving targets
Each MAC maintains its own LCDs on its own schedule. Watching all seven portals by hand is exactly the manual work LCD monitoring software exists to replace.
LCDs are the denial epicenter
Medical-necessity and coverage criteria live in LCDs — so a quiet LCD revision can turn a routinely-paid code into a denial overnight. Daily monitoring catches it first.
Jurisdiction-aware
An LCD only matters if it governs your states. Alerts are mapped to MAC jurisdiction so you don’t chase changes that don’t apply.
Who it’s for
- Revenue cycle leaders protecting net collections
- Coding professionals keeping pace with code and coverage changes
- Compliance officers building audit-ready documentation
- Healthcare finance executives quantifying reimbursement risk
- Reimbursement analysts replacing manual source-watching
- Specialty practice and billing-company leaders
Get CMS & MAC policy alerts by email — free
A weekly digest of the signal-scored changes that affect what you bill. No subscription required.
Frequently asked questions
What is an LCD (Local Coverage Determination)?
A Local Coverage Determination is a decision by a Medicare Administrative Contractor specifying the clinical circumstances under which a service is covered within its geographic jurisdiction. LCDs define medical-necessity criteria, covered diagnoses, and documentation requirements, and failing to meet them is among the most common causes of Medicare claim denial.
What is the difference between an LCD and an NCD?
An NCD (National Coverage Determination) is set by CMS and applies nationwide; an LCD is set by an individual Medicare Administrative Contractor and applies only in its jurisdiction, and only where no NCD already governs. In practice, LCDs are more numerous and change more often, which is why most coverage-driven denials trace back to them.
Which MACs does CLV Intelligence monitor for LCDs?
All seven: Noridian, CGS Administrators, First Coast, National Government Services, Novitas Solutions, Palmetto GBA, WPS. Each LCD change is mapped to its contractor and the states it covers.
How often do LCDs change?
There is no fixed schedule — MACs revise, retire, and issue LCDs on a rolling basis throughout the year. CLV Intelligence scans every business day, so changes typically surface within a day of posting, ahead of their effective date.
Is CLV Intelligence a substitute for compliance or legal advice?
No. CLV Intelligence surfaces, summarizes, and signal-scores official policy changes so your team can act in time, but it is not legal, billing, or compliance advice and it is not an audit certification. Every alert links to the originating government source so you can review the exact language, and final interpretation should be confirmed with qualified compliance counsel.
Explore the platform
NCD tracking platform
National coverage, the day it changes
CMS monitoring software
Track every CMS transmittal, NCD, and rule
Medicare policy monitoring
CMS + all seven MACs in one feed
Specialty reimbursement alerts
CMS & MAC alerts mapped to your specialty
Denial prevention software
Catch denials before they bill
Stop finding out after the claim denies.
See the live feed of CMS and MAC policy changes, or talk to us about coverage for your team.