FDA Approval: ULTOMIRIS (RAVULIZUMAB) — Type 1 - New Molecular Entity
Hematology · Effective 2018-12-21
Specialty intelligence
Hematology Reimbursement Alerts
Daily CMS policy updates, MAC LCD revisions, and coding guidance for Hematology billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.
Total alerts
33
Average signal
61/100
Sources monitored
15+
Latest Hematology alerts
33FDA Approval: SOLIRIS (ECULIZUMAB) — Type 1 - New Molecular Entity
Hematology · Effective 2007-03-16
LCD L36117: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — CGS
Hematology · Effective 2025-05-15
+ 30 more Hematology alerts
Sign in to see the full alert feed →What is Hematology reimbursement leakage costing you?
Calculate your ROI with Hematology-specific CMS benchmarks pre-populated.
MAC contractor coverage
Hematology billing is subject to both national CMS policy and regional MAC contractor Local Coverage Determinations (LCDs). CLV Intelligence monitors all MAC contractor sites — Noridian, CGS, First Coast, NGS, Novitas, Palmetto GBA, and WPS — for LCD updates affecting Hematology codes. Coverage criteria vary by contractor jurisdiction.
NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS
Get Hematology alerts by email — free
Weekly digest of CMS and MAC policy changes for Hematology billing teams.
Frequently asked questions
What MAC contractors issue LCDs for Hematology billing?
Hematology billing is subject to regional Local Coverage Determinations (LCDs) from all seven Medicare Administrative Contractors: Noridian, CGS Administrators, First Coast Service Options, National Government Services, Novitas Solutions, Palmetto GBA, and WPS Government Health Administrators. Coverage criteria and medical necessity requirements vary by contractor jurisdiction. CLV Intelligence monitors all MAC contractor sites daily for LCD updates affecting Hematology codes.
How often does CMS update Hematology reimbursement policy?
CMS updates the Physician Fee Schedule annually, effective January 1, with proposed rules published in the summer and final rules in November. MAC contractors issue LCD updates on a rolling basis throughout the year with no fixed schedule. The Federal Register publishes proposed and final rules affecting Hematology reimbursement on a continuous basis. CLV Intelligence monitors all three sources daily and surfaces updates by signal strength.
What is a Local Coverage Determination (LCD) and how does it affect Hematology billing?
A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor specifying under what clinical circumstances a particular service is covered within its geographic jurisdiction. For Hematology billing teams, LCDs define medical necessity criteria, covered diagnoses, and documentation requirements for specific procedures. Failure to comply with LCD requirements is among the most common causes of Medicare claim denial in Hematology practices.
Reimbursement guides & resources
Plain-language guides to the policy cycles that drive Hematology reimbursement — the fee schedule, ICD-10, HCPCS, and Local Coverage Determinations.
2027 Fee Schedule Guide
How the CY2027 Medicare Physician Fee Schedule works and what to track.
ICD-10 Change Center
The FY2027 ICD-10-CM update cycle and the October 1 effective date.
HCPCS Quarterly Update
How HCPCS Level II changes every quarter — Jan, Apr, Jul, Oct.
Tracking LCD Changes
How LCDs change across all seven MACs and how to track them.
2027 Prep Checklist
A free, printable checklist for the CY2027 fee schedule cycle.
Other specialties