Medicare Coverage Change Impact Report

Healthcare policy and coverage research teams enter public CMS national coverage watches; the input is a saved search by source, document, keyword, status, topic, or date. The Actor reads only the official CMS Medicare Coverage API v1 public national endpoints and compares each response with an isolated recurring baseline. The output is source-linked NCD/NCA change alerts, a descriptive coverage impact report, and an optional JSON export; baseline and unchanged checks emit zero rows and zero charges.

Store Quickstart

{
  "watches": [
    {
      "id": "national-updates",
      "sources": [
        "whats_new_national"
      ],
      "keywords": [
        "coverage"
      ],
      "effectiveDateFrom": "2026-01-01",
      "effectiveDateTo": "2026-12-31"
    }
  ],
  "monitorKey": "national-updates-2026",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}

1. Run the first watch with initialRunMode: "baseline_only" to establish a free snapshot.
2. Run the same monitorKey later with generateReport: true and emitUnchanged: false.
3. Use initialRunMode: "emit_backfill" only when you explicitly want the current matching public records and a paid report immediately.
4. Set emitExport: true when an external workflow needs the source-linked JSON export.

The Actor uses no API key and no CMS license agreement token. It never calls the license-agreement endpoint and never sends an Authorization header.

Input Examples

1. National updates watch

{
  "watches": [{
    "id": "national-updates",
    "sources": ["whats_new_national"],
    "keywords": ["coverage"],
    "effectiveDateFrom": "2026-01-01",
    "effectiveDateTo": "2026-12-31"
  }],
  "monitorKey": "national-updates-2026",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}

2. NCD and NCA watch

{
  "watches": [{
    "id": "ncd-nca-policy",
    "sources": ["ncd", "nca_cal"],
    "keywords": ["diagnostic"],
    "statuses": ["Published"]
  }],
  "monitorKey": "ncd-nca-policy",
  "initialRunMode": "emit_backfill",
  "generateReport": true,
  "emitExport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}

3. Public NCD/NCA data watch

{
  "watches": [{
    "id": "specific-public-documents",
    "sources": ["annual", "nca_cal"],
    "documentIds": ["NCD-EXAMPLE-2026"],
    "topics": ["technology"]
  }],
  "monitorKey": "specific-public-documents",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitExport": true,
  "maxRecordsPerWatch": 100,
  "maxChargeUsd": 25
}

Output

The primary value rows are:

• cms-coverage-change-alert: one source-linked alert for a newly observed or changed public CMS coverage record.
• cms-coverage-impact-report: a descriptive report grouped by source, NCD/NCA type, status, topic, and effective date.
• cms-coverage-export: a compact JSON-ready export of normalized public records.
• cms-coverage-row: optional low-priced normalized public record rows when emitRawRows is true.

Normalized records contain public fields such as documentId, documentType, title, status, effectiveDate, publicationDate, lastUpdatedDate, topic, description, and sourceUrl. No contact fields, API keys, Authorization values, or license tokens are emitted.

See docs/sample-output.json for a representative alert, report, export, and row payload. It is illustrative and is not a live CMS result.

Pricing

Event	Price	When it is emitted
cms-coverage-row	$0.005	Optional normalized public row for a new or changed record
cms-coverage-change-alert	$0.20	New or changed public coverage record is detected
cms-coverage-impact-report	$10.00	An explicit change set is summarized
cms-coverage-export	$6.00	An explicit change set is exported

There is no start charge. A first baseline_only run saves state and emits 0 rows / 0 charge. A later unchanged run also emits 0 rows / 0 charge, regardless of emitUnchanged. maxChargeUsd is checked before any row is pushed; a state-save failure fails closed and does not report a successful run.

Compliance Guardrails

• Official CMS Medicare Coverage API v1 public national list-report endpoints only: What's New National, National Coverage NCD, National Coverage NCA/CAL, and National Coverage Annual.
• The Actor does not call /v1/metadata/license-agreement/ or any endpoint marked as requiring a license agreement token.
• No login, browser session, Authorization header, private document, patient data, or non-public comment is used.
• The Actor does not provide medical advice, insurance advice, reimbursement advice, legal advice, coding advice, or coverage guarantees.
• It does not claim CMS endorsement, approval, certification, affiliation, or payment likelihood.
• Verify the current CMS source record and applicable local policy before making a healthcare, policy, operational, or commercial decision.

See docs/source-compliance.md for the endpoint allowlist and prohibited uses.

Run the next report

• CMS Provider Ownership & Quality Change Report for source-linked provider ownership and quality changes.
• DailyMed Label Change Watch Report for public drug-label metadata and version changes.
• FDA 510(k) Device Clearance Landscape Report for public device clearance record changes.

Source

• CMS Coverage API documentation
• CMS Coverage API FAQ
• CMS Medicare Coverage Center