CMS Coverage

List local coverage articles from CMS Medicare Coverage Database. Articles provide Medicare billing and coding guidance from Medicare Administrative Contractors (MACs). Filter by contractor or state.

List Local Coverage Determinations (LCDs) from CMS Medicare Coverage Database.

List proposed Local Coverage Determinations (LCDs) from CMS Medicare Coverage Database.

List SAD (Statistical Analysis Durable) exclusion items from CMS Medicare Coverage Database.

Get revision history for a local coverage article. Requires license token from get_license_token tool. Returns article version changes with dates and explanations.

Get revision history for a Local Coverage Determination. Requires license token from get_license_token tool. Returns LCD version changes with dates and explanations.

Get data capture periods from CMS Medicare Coverage Database. Returns list of update periods with period IDs, start dates, and end dates used for tracking data refreshes.

Get list of US states for filtering CMS Medicare coverage data. Returns state IDs and names for use with local coverage queries.

Get contract subtypes from CMS Medicare Coverage Database. Returns contract subtype IDs and names for filtering coverage data by Medicare contractor types.

Get license agreement token for accessing licensed CMS Coverage API endpoints. Token required for get_article_revision_history and get_lcd_revision_history tools. Valid for 1 hour.

List National Coverage Determinations (NCDs) from CMS Medicare Coverage Database. NCDs are national policy decisions on whether Medicare covers items or services. Filter by status (active/retired).

List National Coverage Analyses (NCAs) from CMS Medicare Coverage Database. NCAs document CMS review process for coverage decisions. Filter by status (open/closed).

List MEDCAC (Medicare Evidence Development & Coverage Advisory Committee) meetings from CMS. Returns advisory committee meetings with topics, dates, and meeting details.

List Medicare Coverage Documents (MCDs) from CMS Medicare Coverage Database. MCDs provide national coverage information and guidance for Medicare items and services.

List Technology Assessments (TAs) from CMS Medicare Coverage Database. TAs provide systematic evaluation of medical technologies to inform Medicare coverage decisions.

List Coding Analyses for Labs (CALs) from CMS Medicare Coverage Database. CALs provide coverage and coding guidance for clinical diagnostic laboratory tests. Filter by status.