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Physician Fee Schedule Reimbursement Alerts

Daily CMS policy updates, MAC LCD revisions, and coding guidance for Physician Fee Schedule billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.

Critical alerts active

Total alerts

32

Average signal

70/100

Sources monitored

15+

Latest Physician Fee Schedule alerts

32

Federal Register Final Rule: Medicare and Medicaid Programs; CY 2024 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program; Corrections

Physician Fee Schedule · Effective 2024-02-12

Federal Register Final Rule: Medicare and Medicaid Programs; CY 2024 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program

Physician Fee Schedule · Effective 2024-01-01

Federal Register Final Rule: Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction

Physician Fee Schedule · Effective 2026-03-12

+ 29 more Physician Fee Schedule alerts

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MAC contractor coverage

Physician Fee Schedule 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 Physician Fee Schedule codes. Coverage criteria vary by contractor jurisdiction.

NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS

Get Physician Fee Schedule alerts by email — free

Weekly digest of CMS and MAC policy changes for Physician Fee Schedule billing teams.

Frequently asked questions

What MAC contractors issue LCDs for Physician Fee Schedule billing?

Physician Fee Schedule 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 Physician Fee Schedule codes.

How often does CMS update Physician Fee Schedule 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 Physician Fee Schedule 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 Physician Fee Schedule 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 Physician Fee Schedule 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 Physician Fee Schedule practices.

Reimbursement guides & resources

Plain-language guides to the policy cycles that drive Physician Fee Schedule 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.

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