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POST
Calculate claim-scoped payment

Authorizations

X-API-Key
string
header
required

Body

application/json

Claim-scoped payment composition: many lines + a DX list at one CCN.

ccn
string
required

6-digit Medicare Provider Number

Pattern: ^\d{6}$
lines
PaymentClaimLine · object[]
required
Required array length: 1 - 25 elements
date_of_service
string | null

YYYY-MM-DD for NCCI/MUE versioning

dx
string[]

ICD-10-CM diagnosis codes

payer
string | null

Payer name (unused by fee-schedule math)

place_of_service
string | null

Claim-level POS default

qpp
boolean
default:true

Use QPP conversion factor

Response

Per-line allowed amounts, OPPS packaging, NCCI, DX coverage

Claim rollup: per-line allowed, OPPS packaging, NCCI, DX coverage.

ccn
string
required
lines
PaymentClaimLineResult · object[]
required
totals
PaymentClaimTotals · object
required
applicable_blocks
string[]
coverage
PaymentClaimCoverage · object[]
dx
string[]
methodology
string | null
ncci_clean
boolean
default:true
ncci_conflicts
NCCIBatchConflict · object[]
policy_rules
PolicyRuleResponse · object[]
reliability
ReliabilityMetadata · object

User-visible reliability metadata attached to API responses.