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from $13.40 / 1,000 policy jurisdiction records

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CMS MAC Policy Jurisdiction Map

Try for free

One structured record per (LCD policy × administering MAC contractor × covered jurisdiction state) from the official CMS Medicare Coverage Database.

Pricing

from $13.40 / 1,000 policy jurisdiction records

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NexGen Watch

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4 days ago

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🔔 CMS MAC Policy Jurisdiction Map

One structured record per (LCD policy × administering MAC contractor × covered jurisdiction state) from the official CMS Medicare Coverage Database — the relationship facts that say which Medicare Administrative Contractor administers a policy in which state, with the jurisdiction's active and termination dates. Built for reimbursement, market-access, and compliance teams mapping the MAC jurisdiction landscape.

Differentiation: the MAC↔policy↔state relationship is buried across five relational tables in the CMS export; this actor joins them into one flat, deduplicated fact per policy-contractor-state, keyed on a source-native composite id, with every personal-contact field stripped and the CMS licence carried.

Output is one cms_mac_policy_jurisdiction row per result; billing is pay-per-event, the value event being one policy jurisdiction record (a $0.02 start fee per run, then $0.02 per policy jurisdiction 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 XeZoZhPV7o77raHmp on build 0.1.9 (2026-09-19), the same input as the Quick start below — every value is as the source published it (emails masked, long text shortened):

lcd_id	policy_title	contractor_bus_name	contractor_url	jurisdiction_state	active_date
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Florida	1900-01-01
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Puerto Rico	1900-01-01
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Virgin Islands	1900-01-01
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Florida	1900-01-01
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Puerto Rico	1900-01-01
33252	Psychiatric Diagnostic Evaluation and Psychotherapy Services	First Coast Service Options, Inc.	https://medicare.fcso.com	Virgin Islands	1900-01-01
33261	Allergy Testing	First Coast Service Options, Inc.	https://medicare.fcso.com	Florida	1900-01-01
33261	Allergy Testing	First Coast Service Options, Inc.	https://medicare.fcso.com	Puerto Rico	1900-01-01

The run finished with the status message: CAPPED: delivered 50 of 24872 unique rows (maxRecords=50). billable=50

✅ 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_mac_policy_jurisdiction
lcd_id (string/null) — e.g. 33252
lcd_version (string/null) — e.g. 29
policy_title (string/null) — e.g. Psychiatric Diagnostic Evaluation and Psychotherapy Services
display_id (string/null) — null in every sample row
contractor_id (string/null) — e.g. 368
contractor_bus_name (string/null) — e.g. First Coast Service Options, Inc.
contractor_number (string/null) — e.g. 09101
contractor_type_id (string/null) — e.g. 12
contractor_url (string/null) — e.g. https://medicare.fcso.com
jurisdiction_state_id (string/null) — e.g. 12
jurisdiction_state_abbrev (string/null) — e.g. FL
jurisdiction_state (string/null) — e.g. Florida
active_date (string/null) — e.g. 1900-01-01
term_date (string/null) — null in every sample row
source (string/null) — e.g. cms-mac-policy-jurisdiction-map
release_date (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. 2026-09-19T00:29:01Z
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
terminal (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
scope (string/null) — null in every sample row
note (string/null) — null in every sample row

✅ What you get

record_type (string/null) — e.g. cms_mac_policy_jurisdiction
lcd_id (string/null) — e.g. 33252
lcd_version (string/null) — e.g. 29
policy_title (string/null) — e.g. Psychiatric Diagnostic Evaluation and Psychotherapy Services
display_id (string/null) — null in every sample row
contractor_id (string/null) — e.g. 368
contractor_bus_name (string/null) — e.g. First Coast Service Options, Inc.
contractor_number (string/null) — e.g. 09101
contractor_type_id (string/null) — e.g. 12
contractor_url (string/null) — e.g. https://medicare.fcso.com
jurisdiction_state_id (string/null) — e.g. 12
jurisdiction_state_abbrev (string/null) — e.g. FL
jurisdiction_state (string/null) — e.g. Florida
active_date (string/null) — e.g. 1900-01-01
term_date (string/null) — null in every sample row
source (string/null) — e.g. cms-mac-policy-jurisdiction-map
release_date (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. 2026-09-19T00:07:53Z
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
terminal (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
scope (string/null) — null in every sample row
note (string/null) — null in every sample row

✅ What you get

record_type (string/null) — e.g. cms_mac_policy_jurisdiction
lcd_id (string/null) — e.g. 33252
lcd_version (string/null) — e.g. 29
policy_title (string/null) — e.g. Psychiatric Diagnostic Evaluation and Psychotherapy Services
display_id (string/null) — null in every sample row
contractor_id (string/null) — e.g. 368
contractor_bus_name (string/null) — e.g. First Coast Service Options, Inc.
contractor_number (string/null) — e.g. 09101
contractor_type_id (string/null) — e.g. 12
contractor_url (string/null) — e.g. https://medicare.fcso.com
jurisdiction_state_id (string/null) — e.g. 12
jurisdiction_state_abbrev (string/null) — e.g. FL
jurisdiction_state (string/null) — e.g. Florida
active_date (string/null) — e.g. 1900-01-01
term_date (string/null) — null in every sample row
source (string/null) — e.g. cms-mac-policy-jurisdiction-map
release_date (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. 2026-09-18T21:26:25Z
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
terminal (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
scope (string/null) — null in every sample row
note (string/null) — null in every sample row

⚙️ Sample inputs

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

{
  "lcdIds": [],
  "states": [],
  "contractorIds": [],
  "maxRecords": 50
}

The sample run charged exactly: 4 × $0.02 apify-actor-start + 50 × $0.02 policy_jurisdiction_record = $1.08 on the Free tier — every delivered row was billed.

2. A smaller, narrowed run

{
  "lcdIds": [],
  "states": [],
  "contractorIds": [],
  "maxRecords": 5
}

Caps the run at 5 rows — about $0.12 on the Free tier ($0.02 start + 5 × $0.02).

3. A full-size run

{
  "lcdIds": [],
  "states": [],
  "contractorIds": [],
  "maxRecords": 2500
}

Up to 2500 rows (the schema default for maxRecords) — about $50.02 on the Free tier ($0.02 start + 2500 × $0.02) if the source has that many.

4. A filtered run

{
  "lcdIds": [],
  "states": [],
  "contractorIds": [],
  "maxRecords": 50,
  "fieldMatch": {
    "policy_title": "Psychiatric Diagnostic Evaluation and Psychotherapy Services"
  }
}

Keeps only rows whose policy_title contains Psychiatric Diagnostic Evaluation and Psychotherapy Services (a value from the sample run above), matched case-insensitively after the source is read and before the maxRecords cap, so the cap counts matches and only delivered matches are billed. searchText does the same across every column. Zero matches end the run as EMPTY_SELECTION with no row charged — if the source has moved on since that sample run, pick a value you see in your own first run. The source is still read in full — this narrows what you receive and pay for, not what the source serves.

🧾 JSON sample record

One real record from run XeZoZhPV7o77raHmp, exactly as it lands in the dataset (emails masked, long text shortened):

{
  "record_type": "cms_mac_policy_jurisdiction",
  "lcd_id": "33252",
  "lcd_version": "29",
  "policy_title": "Psychiatric Diagnostic Evaluation and Psychotherapy Services",
  "display_id": "",
  "contractor_id": "368",
  "contractor_bus_name": "First Coast Service Options, Inc.",
  "contractor_number": "09101",
  "contractor_type_id": "12",
  "contractor_url": "https://medicare.fcso.com",
  "jurisdiction_state_id": "12",
  "jurisdiction_state_abbrev": "FL",
  "jurisdiction_state": "Florida",
  "active_date": "1900-01-01",
  "term_date": null,
  "source": "cms-mac-policy-jurisdiction-map",
  "release_date": null,
  "source_url": "https://www.cms.gov/medicare-coverage-database/",
  "observed_at": "2026-09-19T00:29:01Z",
  "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. Pacing: CRAWL_DELAY=0.0.

Terminal states. A run ends NORMAL, CAPPED (your cap was reached), PARTIAL (something was withheld and the message says what), GENUINE_EMPTY (the source was read and truly had nothing in scope) or BLOCKED (the source refused or changed shape — the run FAILS loud and bills nothing). A zero-row run is never reported as a silent success.

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

🔧 How it works

Source

The official current_lcd.zip from downloads.cms.gov. The .mdb is not read — the CSV members are joined (lcd_x_contractor ⋈ contractor ⋈ contractor_jurisdiction ⋈ state_lookup ⋈ lcd), with header layout canaries that fail loud (unbilled) on shell body, header drift, or zero-parse.

Privacy & licence

Personal-contact fields are excluded at ingest: the contractor medical-director name and title, phone, fax, email, and street address are never emitted. Only the public business name, number, and website remain.
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.

💰 Pricing example

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

Worked at the live Free-tier price:

8 policy jurisdiction records: $0.02 start + 8 × $0.02 = $0.18
25 policy jurisdiction records: $0.02 start + 25 × $0.02 = $0.52
2500 policy jurisdiction 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.

Yield on the sample run: CAPPED: delivered 50 of 24872 unique rows (maxRecords=50). billable=50. 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 (CRAWL_DELAY=0.0) 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.

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