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# CMS Coverage

**Authentication:** No authentication required (public API).

## Sample use cases

* Look up Medicare coverage for CPT code 99213 in California.
* List local coverage determinations published in the last 90 days for cardiology procedures.
* Search for national coverage policies on continuous glucose monitoring.

## Available Tools

#### list\_local\_coverage\_articles

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\_lcds

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

#### list\_proposed\_lcds

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

#### list\_sad\_exclusion\_list

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

#### get\_article\_revision\_history

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\_lcd\_revision\_history

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\_update\_periods

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\_states

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

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

#### get\_license\_token

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\_ncds

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\_ncas

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\_meetings

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

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

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

#### list\_cals

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.