7 MAC Jurisdictions · Federal CFR · CMS Data v1.10 — Coverage Alerts & Data Explorer

Medicare Regulatory Intelligence
for the Professionals Who Need It

Research, compare, and monitor Medicare regulations, coverage determinations, and payment data. AI-assisted analysis grounded in authoritative CMS sources — with full citations and a professional research environment.

AI-Powered Research Tool — Informational Use Only. Medicare Laws Expert delivers AI-generated analysis across 7 MAC jurisdictions. Outputs are produced by large language models — including technology from Anthropic and Google — and do not constitute legal advice. Always consult a licensed attorney for legal guidance.

49,000+Legal Documents
7MAC Jurisdictions
3,579Active Sources
38M+CMS Data Points
Research Assistant — RAG-Powered
Built for long research sessions

A Research Environment Designed to Disappear

The interface gets out of the way. The regulation stays front and center. Nine precision-crafted themes adapt to your environment and preference — all persisted across sessions.

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42 CFR § 405.920
Medicare Claims and Appeals
The initial determination is the first decision made on a claim for benefits under Medicare Part A or Part B…
Federal·42 CFR Part 405
NCD 20.9.1
Screening for Lung Cancer with LDCT
Effective February 10, 2022, CMS covers lung cancer screening with LDCT for eligible beneficiaries between 50 and 77 years of age…
National·Coverage Determination
LCD L35014
Physical Therapy Services
Coverage is provided for physical therapy services that are medically necessary and require the skills of a licensed therapist…
MAC·Palmetto GBA
9 precision-crafted themes — switch instantly, remembered across every session
What you can do

Platform Capabilities

Purpose-built tools for Medicare regulatory research and analysis.

AI Research Assistant

Ask questions in plain English and receive answers grounded in CMS regulations, coverage determinations, and payment policy. Every response includes citations to the specific sources referenced.

Coverage Determination Search

Search 344 National Coverage Determinations and 961 Local Coverage Determinations. Track coverage policy changes across all 7 MAC jurisdictions.

Medicare Payment Data

Explore 38 million CMS data rows — physician utilization, Part D prescribing, inpatient and outpatient charges, facility data, and geographic variation.

MAC Jurisdiction Navigator

Navigate the 7 Medicare Administrative Contractor regions. Compare coverage policies and payment rates across jurisdictions.

Clinical Evidence Integration

PubMed integration surfaces peer-reviewed clinical evidence alongside regulatory citations. Strengthen coverage appeal arguments with published research.

Coverage Change Alerts

Subscribe to NCD and LCD changes by topic, MAC jurisdiction, or specific coverage determination. Get notified when coverage policy updates affect your practice.

The corpus

Comprehensive Medicare Coverage

Federal law, CMS policy, and MAC-level coverage determinations aggregated from authoritative sources — growing daily.

49,000+Legal Documents
3,579Active Sources
7MAC Jurisdictions
38M+CMS Data Points

Authoritative Data Sources

Code of Federal Regulations (42 CFR) Social Security Act (Title XVIII) National Coverage Determinations (NCDs) Local Coverage Determinations (LCDs) CMS Internet-Only Manuals (IOM) Conditions of Participation (CoPs) Fee Schedules & Payment Data PubMed Clinical Evidence Federal Register Notices CMS Transmittals State Operations Manual (SOM) Medicare Provider Manuals
344
National Coverage Determinations
961
Local Coverage Determinations
96
CMS Manual Chapters (IOM)
520
Glossary Terms
Who uses it

Built for the Medicare Policy Ecosystem

Designed to serve the professionals who shape, interpret, and navigate Medicare law.

Healthcare Attorneys

Accelerate Medicare legal research with cited regulatory references. Coverage determinations, appeals authority, and compliance requirements at your fingertips.

Compliance Officers

Monitor coverage policy changes, track CoP requirements by facility type, and stay ahead of regulatory updates across MAC jurisdictions.

Medical Billing Specialists

Look up HCPCS codes, DRG payments, and coverage criteria. Cross-reference LCDs and NCDs to validate billing decisions.

Coverage Appeal Consultants

Build stronger appeal arguments with NCD/LCD citations, clinical evidence from PubMed, and cross-jurisdiction payment comparisons.

Hospital Administrators

Track facility compliance requirements, geographic payment variation, and coverage determination changes that affect your institution.

Medicare Advantage Plans

Monitor coverage policy changes across jurisdictions, compare payment data, and ensure plan offerings align with current CMS requirements.

Under the hood

How It Works

From official CMS source material to actionable Medicare regulatory intelligence.

1

Aggregate

3,579 active sources continuously monitored — NCDs, LCDs, CMS manuals, federal regulations, and CMS structured data. Coverage API integration pulls the latest determinations automatically.

2

Analyze & Index

49,000+ legal document chunks processed into a high-fidelity knowledge base with 768-dim vector embeddings. 38 million CMS data rows imported for structured queries.

3

Research & Report

Query using natural language or targeted search. AI synthesizes findings from regulations, coverage determinations, payment data, and clinical evidence with full citations.

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