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GET
Medicaid PTP edit — code pair

Authorizations

X-API-Key
string
header
required

Query Parameters

col1_proc_cd
string
required

Column 1 (comprehensive) procedure code

col2_proc_cd
string
required

Column 2 (component) procedure code

claim_type
enum<string> | null

prac (practitioner), hosp (outpatient hospital), or dme

Available options:
prac,
hosp,
dme
date_of_service
string<date> | null

Date of service (YYYY-MM-DD); selects the edit effective on that date.

Response

Successful Response

Medicaid PTP bundling edit for a code pair.

col1_proc_cd
string
required

Column 1 (comprehensive) code

col2_proc_cd
string
required

Column 2 (component) code

date_of_service
string | null
edit_delete_dt
string | null

Deletion date (empty if active)

edit_effective_dt
string | null

When this PTP edit took effect

loaded_at
string<date-time> | null

When rcintel-data curated this row

modifier
string | null

Modifier indicator: 0=NOT ALLOWED, 1=ALLOWED, 9=NOT APPLICABLE

modifier_allowed
boolean | null

True when modifier is 1 or 9

program
string
default:medicaid
Allowed value: "medicaid"
ptp_edit_rationale
string | null

CMS edit rationale

ptp_type
string | null

PTP table: prac, hosp, or dme