🔔 CMS Local Coverage Determinations Change Scraper

Scrape Medicare Local Coverage Determination (LCD) changes: one record per policy added, changed or removed between the last CMS export and the current one. Run it once and you get the current records as a dataset; put it on a schedule to keep the list current.

Differentiation: this is change detection, not a policy dump. Two official ZIP snapshots are diffed pairwise on content — a sha256 over each policy's substantive fields (version, title, effective/end dates, status, retirement) — never on last_updated timestamps alone, so a cosmetic re-publish does not fire a false alert. The first run seeds silently; later runs bill only real movement.

Output is one cms_lcd_change row per result; billing is pay-per-event, the value event being one policy change record (a $0.02 start fee per run, then $0.02 per policy change record). Source: downloads.cms.gov, www.cms.gov.

No login, no API key and no CAPTCHA solving are involved: the source is read logged-out with an identified contact User-Agent.

📊 Sample Output

Real rows from run rqR0TAwsNDOLOUpMD on build 0.1.3 (2026-09-24), the same input as the Quick start below — every value is as the source published it (emails masked, long text shortened):

lcd_id	change_type	policy_title	status	license	attribution
40469	added	MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in R	P	CMS Medicare Coverage Database — U.S. Government public data; CPT is c	U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Datab
40471	added	MolDX: Next-Generation Sequencing for Hematologic Malignancies and Sus	P	CMS Medicare Coverage Database — U.S. Government public data; CPT is c	U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Datab
40473	added	MolDX: Genome-Wide Molecular Methodologies for the Detection of Copy N	P	CMS Medicare Coverage Database — U.S. Government public data; CPT is c	U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Datab
38582	removed	MolDX: Molecular Testing for Solid Organ Allograft Rejection	A	CMS Medicare Coverage Database — U.S. Government public data; CPT is c	U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Datab
38441	changed	MolDX: Blood Product Molecular Antigen Typing	A	CMS Medicare Coverage Database — U.S. Government public data; CPT is c	U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Datab

✅ What you get

Each row is flat JSON with these fields (from the dataset schema and the sample run; a field the source does not publish for a given row is null):

• record_type (string/null) — e.g. cms_lcd_change
• lcd_id (string/null) — e.g. 40469
• change_type (string/null) — e.g. added
• lcd_version (string/null) — e.g. 3
• prior_version (string/null) — e.g. 11
• policy_title (string/null) — e.g. MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in Renal Carci
• display_id (string/null) — e.g. 40470
• orig_det_eff_date (string/null) — e.g. 2021-06-06
• rev_eff_date (string/null) — e.g. 2026-09-24
• prior_rev_eff_date (string/null) — e.g. 2026-06-18
• rev_end_date (string/null) — null in every sample row
• status (string/null) — e.g. P
• date_retired (string/null) — null in every sample row
• source_url (string/null) — e.g. https://www.cms.gov/medicare-coverage-database/
• observed_at (string/null) — e.g. 2026-09-24T17:34:07Z
• license (string/null) — e.g. CMS Medicare Coverage Database — U.S. Government public data; CPT is copyright A
• attribution (string/null) — e.g. U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Database (https
• source (string/null) — null in every sample row
• release_date (string/null) — null in every sample row
• terminal (string/null) — null in every sample row
• baseline_id (string/null) — null in every sample row
• reported_total (string/integer/null) — null in every sample row
• raw_seen (string/integer/null) — null in every sample row
• duplicates (string/integer/null) — null in every sample row
• unique_found (string/integer/null) — null in every sample row
• delivered (string/integer/null) — null in every sample row
• change_types (array/null) — null in every sample row
• scope (string/null) — null in every sample row
• note (string/null) — null in every sample row

✅ What you get

✅ What you get

⚙️ Sample inputs

1. Quick start — the Store example (this is what the sample above came from)

{
  "baselineId": "default",
  "changeTypes": [
    "added",
    "changed",
    "removed"
  ],
  "maxRecords": 50
}

Returns up to 50 rows.

2. A smaller, narrowed run

{
  "baselineId": "default",
  "changeTypes": [
    "added",
    "changed",
    "removed"
  ],
  "maxRecords": 5
}

Caps the run at 5 rows; same billing shape as the sample run above.

3. A full-size run

{
  "baselineId": "default",
  "changeTypes": [
    "added",
    "changed",
    "removed"
  ],
  "maxRecords": 2500
}

The same input run on a schedule; each run is billed only for what it delivers.

🧾 JSON sample record

One real record from run rqR0TAwsNDOLOUpMD, exactly as it lands in the dataset (emails masked, long text shortened):

{
  "record_type": "cms_lcd_change",
  "lcd_id": "40469",
  "change_type": "added",
  "lcd_version": "3",
  "prior_version": null,
  "policy_title": "MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in Renal Carcinoma",
  "display_id": "40470",
  "orig_det_eff_date": null,
  "rev_eff_date": null,
  "prior_rev_eff_date": null,
  "rev_end_date": null,
  "status": "P",
  "date_retired": null,
  "source_url": "https://www.cms.gov/medicare-coverage-database/",
  "observed_at": "2026-09-24T17:34:07Z",
  "license": "CMS Medicare Coverage Database — U.S. Government public data; CPT is copyright American Medical Association (CPT/HCPCS long/short descriptors are excluded from this output).",
  "attribution": "U.S. Centers for Medicare & Medicaid Services, Medicare Coverage Database (https://www.cms.gov/medicare-coverage-database/)"
}

🔧 How it works

Source. The actor reads downloads.cms.gov, www.cms.gov — endpoints: https://downloads.cms.gov/medicare-coverage-database/downloads/exports/current_lcd.zip, https://www.cms.gov/medicare-coverage-database/. Public pages and feeds only; nothing behind a login.

Transport. Plain HTTPS from the Apify platform, no proxy. robots.txt is read first and a disallowed path is never fetched. Every request carries an identified contact User-Agent.

Charging. Each policy change record is charged at the moment it is pushed (policy_change_record); a row that fails to charge is not delivered, so the dataset count always equals the charged count.

🔧 How it works

🔧 How it works

Seeding law

The first run for a given baselineId seeds: it saves the baseline, emits zero alerts, and charges nothing (only the platform start). Every later run emits the changes since that baseline and advances it. This is why a seed run never bills you for the whole policy set as if it were all new.

Source

The official current_lcd.zip from downloads.cms.gov (the lcd.csv member — the .mdb is not read), with header layout canaries that fail loud (unbilled) on a shell body, header drift, or zero-parse. A failed/blocked read never overwrites the baseline, so the next run cannot see a phantom mass-removal.

Compliance & licence

• CPT/HCPCS descriptor fields are excluded by position and never emitted.
• Every record carries the CMS licence (license) and attribution (attribution).

What is not done. No login, no cookie or CAPTCHA bypass, no private or personal-account data, no browser automation.

⏰ Optional: run it on a schedule

A single run returns the current records. If you also want to be told what changed over time, open the actor in Apify Console → Schedules → Create new, add this actor with the input you want, and pick a cadence:

• Daily — 0 7 * * * (07:00 UTC): catch changes within a day.
• Weekly — 0 7 * * 1: a Monday digest.

Each run is independent; keep the same input on the schedule so the results stay comparable. Schedules can also POST results to a webhook (Console → Integrations).

💰 Pricing example

Event	Free	Bronze	Silver	Gold
Actor Start (apify-actor-start)	$0.02	$0.02	$0.02	$0.02
Policy change record (policy_change_record)	$0.02	$0.018	$0.016	$0.0134

Worked at the live Free-tier price:

• 5 policy change records: $0.02 start + 5 × $0.02 = $0.12
• 25 policy change records: $0.02 start + 25 × $0.02 = $0.52
• 2500 policy change records: $0.02 start + 2500 × $0.02 = $50.02

A run that delivers zero rows charges the $0.02 start fee only. A BLOCKED run (source refused) fails loud and charges no value event. The start fee is charged once per GB of run memory; the default run memory is 4096 MB.

maxRecords is a hard ceiling on what is delivered and billed, never a target.

⚖️ Legal & ToS

This actor reads public, logged-out pages and feeds published by downloads.cms.gov, www.cms.gov. It collects only what the source publishes to any visitor, keeps to the source's robots rules (checked on every run), identifies itself with a contact User-Agent, and does not access accounts, private data or anything behind authentication. Use the output in line with the source's terms and your local law; the intended use is B2B research and monitoring.

❓ FAQ

Q: Do I need an API key or a login?
A: No. The source (downloads.cms.gov, www.cms.gov) is read logged-out; the input schema has no key field and the actor carries no secrets.

Q: Why did my run return 0 rows?
A: Read the run's status message. GENUINE_EMPTY means the source was read and had nothing in scope for your input; BLOCKED means the source refused and the run failed without billing a value event — retry later or narrow the input. A zero-row run bills the start fee only.

Q: How many rows can one run return?
A: Up to maxRecords (default 2500). Raise the cap for a bigger run; you pay per delivered row.

Q: How fresh is the data?
A: Every run reads the source live at run time; nothing is cached between runs. Put it on a schedule for a continuous feed.

Q: What formats can I export?
A: The dataset downloads as JSON, CSV, Excel, XML or RSS from the run's Dataset tab or the Apify API, and any run can push to a webhook or integration.

Q: How is this different from the other NexGen Watch actors actors?
A: Same output shape and billing model; this one covers downloads.cms.gov, www.cms.gov. The siblings under Related Actors cover the other sources or slices — run several on one schedule for a combined feed.

Q: Are there rate limits?
A: The actor paces itself against the source and honours its robots rules; there is no per-buyer limit beyond your Apify plan's concurrency.

🆘 Troubleshooting

• Run FAILED with BLOCKED → the source refused the request or changed its page shape → nothing was billed beyond the start fee; retry after a while, and if it persists open an Issue with the run id.
• Status says CAPPED → your cap (maxRecords) was reached → raise it for a bigger run.
• Input validation error on start → a field is outside the schema's allowed values → start from the Quick start block and change one field at a time.
• Run TIMED-OUT → a very wide request on a slow day → raise the run timeout in Run options or narrow the input; what was delivered before the timeout is still in the dataset.

🔗 Related Actors

• CMS Hospice Facilities Scraper — A clean, structured roster of Medicare-certified hospice facilities in the United States, sourced live from the official CMS provider-data API (https…
• CMS Article ICD-10 Covered Code Matrix — One structured record per versioned Article × ICD-10 COVERED relation from the official CMS Medicare Coverage Database — the Article id and version,…
• CMS Article ICD-10 Non-Covered Code Matrix — One structured record per versioned Article × ICD-10 NON-COVERED relation from the official CMS Medicare Coverage Database — the Article id and versi…
• CMS MAC Policy Jurisdiction Map — One structured record per (LCD policy × administering MAC contractor × covered jurisdiction state) from the official CMS Medicare Coverage Database
• CMS Medicare Coverage Policy Master — One structured policy_record per coverage policy across all three CMS document families — Local Coverage Determinations (LCD), Articles, and National…
• CMS LCD Policy Revision Ledger — One structured revision record per filed LCD revision-history entry from the official CMS Medicare Coverage Database — the LCD policy id, version, re…
• 🏢 About NexGenData — NexGen Watch is NexGenData's fleet of more than 300 public data actors built on official sources, pay-per-result. Browse the catalog at apify.com/nexgenwatch.

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