> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Payer policies in the context of a registered facility

> ``GET /v1/policies`` with the facility's type and state filled in.

The facility's registered ``facility_type`` (e.g. ``fqhc``) and state (MAC
localization) are applied; rows aimed only at other facility types are
dropped. ``GET /v1/policies`` stays the wide-open view.



## OpenAPI

````yaml /docs/openapi.client.json get /v1/facilities/{ccn}/policies
openapi: 3.1.0
info:
  description: >-
    Client API for RCIntel. Authenticate with X-API-Key. See Guides → Which API
    to use.
  summary: Multi-tenant knowledge API for healthcare revenue cycle management.
  title: Healthcare Knowledge Layer
  version: 0.1.0
servers: []
security: []
tags:
  - description: >-
      Cited payer policy lookup — GET /v1/policies and GET /v1/policies/changes.
      Medicare FFS returns NCDs/LCDs/MACs; commercial payers return that payer's
      documents only. Query payer, code, state, plan_type.
    name: policies
  - description: >-
      Payer-policy PDF parse and retrieve for Workspace / Payer Knowledge.
      Service-authenticated (X-Admin-Secret); chunks stored in Postgres.
    name: policy
  - description: >-
      Manufacturer 340B contract-pharmacy policy, fail-closed access, and the
      change feed. Different API from GET /v1/policies.
    name: 340B Policy
  - description: CRD-style prior authorization check, documentation, and vendors.
    name: prior-auth
  - description: Public payer directory (no API key on list/detail).
    name: payers-public
  - description: >-
      Payer network directory — search payers, check prior auth requirements,
      view filing rules, denial patterns, and appeal levels.
    name: payers
  - description: >-
      Resolve healthcare billing knowledge across the L1-L6 layer stack.
      Includes payment calculation, billing guidance, and per-layer queries.
    name: knowledge
  - description: >-
      CMS Fee Schedule lookups — OPPS (Addendum B / APC), DMEPOS (state-level
      pricing), and Clinical Lab Fee Schedule (CLFS).
    name: fee-schedules
  - description: >-
      NCCI (National Correct Coding Initiative) — dedicated MUE limits, PTP
      bundling edits, add-on code edits, and code pair validation. Medicare
      edits under /ncci/*, the separate CMS Medicaid edit set under
      /ncci/medicaid/*.
    name: ncci
  - description: >-
      Service code intelligence — CPT/HCPCS lookup, RVU data, NCCI edits,
      payment calculation, implant/GUDID search, and service group
      classification.
    name: codes
  - description: >-
      Submit asynchronous AI agent jobs for code research, medical necessity,
      and denial resolution. Poll for results and retrieve reasoning traces.
    name: agents
  - description: >-
      Register and manage healthcare facilities by CCN (Medicare Provider
      Number). Each facility is the root entity for knowledge resolution.
    name: facilities
  - description: >-
      NPI Registry — live search against CMS NPPES API for provider and
      organization National Provider Identifiers.
    name: npi
  - description: >-
      OpenFDA drug product lookup by NDC. Includes product-level fields with
      normalized ingredient and package detail.
    name: drugs
  - name: encounter
  - name: mcp
  - description: Health checks, service metadata, and Prometheus metrics.
    name: system
paths:
  /v1/facilities/{ccn}/policies:
    get:
      tags:
        - facilities
      summary: Payer policies in the context of a registered facility
      description: >-
        ``GET /v1/policies`` with the facility's type and state filled in.


        The facility's registered ``facility_type`` (e.g. ``fqhc``) and state
        (MAC

        localization) are applied; rows aimed only at other facility types are

        dropped. ``GET /v1/policies`` stays the wide-open view.
      operationId: list_facility_policies_v1_facilities__ccn__policies_get
      parameters:
        - description: >-
            6-digit CMS Certification Number (facility CCN / Medicare provider
            number).
          in: path
          name: ccn
          required: true
          schema:
            title: Ccn
            type: string
        - description: Payer slug (e.g. medicare_ffs). Omit for every payer.
          in: query
          name: payer
          required: false
          schema:
            anyOf:
              - type: string
              - type: 'null'
            description: Payer slug (e.g. medicare_ffs). Omit for every payer.
            title: Payer
        - description: CPT/HCPCS code. Omit to browse facility-directed policy.
          in: query
          name: code
          required: false
          schema:
            anyOf:
              - type: string
              - type: 'null'
            description: CPT/HCPCS code. Omit to browse facility-directed policy.
            title: Code
        - description: ffs | medicare_advantage | medicaid | commercial
          in: query
          name: plan_type
          required: false
          schema:
            anyOf:
              - type: string
              - type: 'null'
            description: ffs | medicare_advantage | medicaid | commercial
            title: Plan Type
        - description: Point-in-time (YYYY-MM-DD)
          in: query
          name: as_of
          required: false
          schema:
            anyOf:
              - format: date
                type: string
              - type: 'null'
            description: Point-in-time (YYYY-MM-DD)
            title: As Of
        - description: false = only policies that target this facility's type
          in: query
          name: include_general
          required: false
          schema:
            default: true
            description: false = only policies that target this facility's type
            title: Include General
            type: boolean
        - description: Maximum number of records to return.
          in: query
          name: limit
          required: false
          schema:
            default: 50
            maximum: 200
            minimum: 1
            title: Limit
            type: integer
      responses:
        '200':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PolicyLookupResponse'
          description: Policies applicable to this facility's type and MAC
        '422':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
          description: Validation Error
      security:
        - APIKeyHeader: []
components:
  schemas:
    PolicyLookupResponse:
      properties:
        as_of:
          anyOf:
            - type: string
            - type: 'null'
          title: As Of
        code:
          anyOf:
            - type: string
            - type: 'null'
          title: Code
        count:
          title: Count
          type: integer
        facility_type:
          anyOf:
            - type: string
            - type: 'null'
          title: Facility Type
        frequency:
          anyOf:
            - $ref: '#/components/schemas/PostedFrequency'
            - type: 'null'
        geo_codes:
          items:
            type: string
          title: Geo Codes
          type: array
        geo_scope:
          title: Geo Scope
          type: string
        include_general:
          anyOf:
            - type: boolean
            - type: 'null'
          title: Include General
        mac:
          anyOf:
            - additionalProperties: true
              type: object
            - type: 'null'
          title: Mac
        payer:
          anyOf:
            - type: string
            - type: 'null'
          title: Payer
        payers:
          items:
            type: string
          title: Payers
          type: array
        plan_type:
          anyOf:
            - type: string
            - type: 'null'
          title: Plan Type
        policies:
          items:
            $ref: '#/components/schemas/PayerPolicyRow'
          title: Policies
          type: array
        state:
          anyOf:
            - type: string
            - type: 'null'
          title: State
        units:
          anyOf:
            - items:
                $ref: '#/components/schemas/PolicyUnitsRow'
              type: array
            - type: 'null'
          title: Units
        warnings:
          items:
            type: string
          title: Warnings
          type: array
      required:
        - geo_scope
        - count
      title: PolicyLookupResponse
      type: object
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          title: Detail
          type: array
      title: HTTPValidationError
      type: object
    PostedFrequency:
      description: Only filled when a cited policy posts a frequency. Never invented.
      properties:
        max_times:
          title: Max Times
          type: integer
        period:
          title: Period
          type: string
        source_url:
          title: Source Url
          type: string
      required:
        - max_times
        - period
        - source_url
      title: PostedFrequency
      type: object
    PayerPolicyRow:
      description: One cited policy snippet for a payer (and optional code).
      properties:
        article_modifiers:
          description: >-
            Modifiers an LCD billing article references for this code: modifier,
            role (requirement | liability_notice | anatomic | distinct_service |
            ...), cms_description, instruction (the article's own sentences),
            applies_to.
          items:
            additionalProperties: true
            type: object
          title: Article Modifiers
          type: array
        as_of:
          anyOf:
            - type: string
            - type: 'null'
          title: As Of
        bill_types:
          description: LCD article bill types (3-digit CMS codes, e.g. 077 = FQHC)
          items:
            type: string
          title: Bill Types
          type: array
        code:
          default: ''
          title: Code
          type: string
        codes_covered:
          items:
            type: string
          title: Codes Covered
          type: array
        codes_not_covered:
          items:
            type: string
          title: Codes Not Covered
          type: array
        coverage_status:
          anyOf:
            - type: string
            - type: 'null'
          title: Coverage Status
        delegated_entity:
          anyOf:
            - type: string
            - type: 'null'
          title: Delegated Entity
        doc_id:
          default: ''
          title: Doc Id
          type: string
        document_kind:
          anyOf:
            - type: string
            - type: 'null'
          title: Document Kind
        document_version:
          anyOf:
            - type: string
            - type: 'null'
          title: Document Version
        effective_from:
          anyOf:
            - type: string
            - type: 'null'
          title: Effective From
        effective_until:
          anyOf:
            - type: string
            - type: 'null'
          title: Effective Until
        facility_applicability:
          anyOf:
            - type: string
            - type: 'null'
          description: >-
            specific | general | other_facility — set only when facility_type is
            requested
          title: Facility Applicability
        facility_tag_source:
          anyOf:
            - type: string
            - type: 'null'
          description: bill_type | structured | text_match — where facility_types came from
          title: Facility Tag Source
        facility_types:
          description: >-
            Facility type keys this row targets (fqhc, rhc, ...). Empty = names
            none (general).
          items:
            type: string
          title: Facility Types
          type: array
        geo_codes:
          items:
            type: string
          title: Geo Codes
          type: array
        geo_scope:
          default: national
          title: Geo Scope
          type: string
        icd10:
          items:
            type: string
          title: Icd10
          type: array
        ingested_at:
          anyOf:
            - type: string
            - type: 'null'
          title: Ingested At
        kind:
          default: policy
          title: Kind
          type: string
        mac_jurisdiction:
          anyOf:
            - type: string
            - type: 'null'
          title: Mac Jurisdiction
        payer_slug:
          title: Payer Slug
          type: string
        pdf_uri:
          default: ''
          title: Pdf Uri
          type: string
        plan_type:
          anyOf:
            - type: string
            - type: 'null'
          title: Plan Type
        policy_type:
          anyOf:
            - type: string
            - type: 'null'
          title: Policy Type
        rule_text:
          default: ''
          title: Rule Text
          type: string
        source_key:
          default: ''
          title: Source Key
          type: string
        states_excluded:
          items:
            type: string
          title: States Excluded
          type: array
        supersedes_doc_id:
          anyOf:
            - type: string
            - type: 'null'
          title: Supersedes Doc Id
        title:
          anyOf:
            - type: string
            - type: 'null'
          title: Title
      required:
        - payer_slug
      title: PayerPolicyRow
      type: object
    PolicyUnitsRow:
      description: NCCI MUE = max units per day. Not a yearly billed-volume number.
      properties:
        adjudication:
          anyOf:
            - type: string
            - type: 'null'
          title: Adjudication
        mue_per_day:
          title: Mue Per Day
          type: integer
        period:
          default: day
          title: Period
          type: string
        rationale:
          anyOf:
            - type: string
            - type: 'null'
          title: Rationale
        setting:
          title: Setting
          type: string
        source:
          default: cms_ncci_mue
          title: Source
          type: string
      required:
        - mue_per_day
        - setting
      title: PolicyUnitsRow
      type: object
    ValidationError:
      properties:
        ctx:
          title: Context
          type: object
        input:
          title: Input
        loc:
          items:
            anyOf:
              - type: string
              - type: integer
          title: Location
          type: array
        msg:
          title: Message
          type: string
        type:
          title: Error Type
          type: string
      required:
        - loc
        - msg
        - type
      title: ValidationError
      type: object
  securitySchemes:
    APIKeyHeader:
      in: header
      name: X-API-Key
      type: apiKey

````

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