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GET
Compose directory + PA + fee + policy for a claim

Authorizations

X-API-Key
string
header
required

Path Parameters

slug
string
required

Normalized payer slug identifier.

Query Parameters

code
string
required

CPT/HCPCS code (e.g. 90837)

Minimum string length: 1
modifier
string | null

Modifier (e.g. HO)

plan_type
string | null

Plan type for PA resolution

service_category
string | null
default:mental_health

Service category for PA fallback

state
string | null

State code

Response

Successful Response

Single-call compose of directory + PA + fee + policy for a claim context.

code
string
required
payer_name
string
required
payer_slug
string
required
payer_type
string
required
appeal_rules
AppealRuleResponse · object[]
denial_patterns
DenialPatternResponse · object[]
edi_payer_ids
Edi Payer Ids · object
fee
ClaimFeeSnippet · object | null

Fee-schedule / RVU slice for claim intelligence.

filing_rules
FilingRuleResponse · object[]
modifier
string | null
plan_type
string | null
policy_rules
ClaimPolicyRule · object[]
prior_auth
Prior Auth · object | null
prior_auth_rules
PriorAuthRuleResponse · object[]