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GET
Look up payer policies by code, state, and plan type

Authorizations

X-API-Key
string
header
required

Query Parameters

payer
string | null

Payer slug, alias, or claim/EDI id (e.g. uhc, united, 87726). Omit or pass * to return cited rows for every payer, each tagged payer_slug. LCD/NCD never mix into commercial rows.

code
string | null

CPT/HCPCS code

state
string | null

US state (MA, NY). Resolves Medicare MAC.

plan_type
string | null

ffs | medicare_advantage | medicaid | commercial

scope
string | null

general = national only, even if state is sent

as_of
string<date> | null

Point-in-time (YYYY-MM-DD)

limit
integer
default:50

Maximum number of records to return.

Required range: 1 <= x <= 200

Response

Successful Response

count
integer
required
geo_scope
string
required
as_of
string | null
code
string | null
frequency
PostedFrequency · object | null

Only filled when a cited policy posts a frequency. Never invented.

geo_codes
string[]
mac
Mac · object | null
payer
string | null
payers
string[]
plan_type
string | null
policies
PayerPolicyRow · object[]
state
string | null
units
PolicyUnitsRow · object[] | null
warnings
string[]