Look up payer policies by code, state, and plan type
policies
Look up payer policies by code, state, and plan type
Return cited payer policy rows.
Massachusetts and New York Medicare FFS share MAC JK (NGS). Omitting
state or sending scope=general returns national NCDs / transmittals
only. Each row includes geo_scope, policy_type, codes_covered,
codes_not_covered, icd10, and delegated_entity. Arrays are
empty when the document mart has not extracted them yet.
GET
Look up payer policies by code, state, and plan type
Authorizations
Query Parameters
Payer slug, e.g. medicare_ffs or uhc
CPT/HCPCS code
US state (MA, NY). Resolves Medicare MAC.
ffs | medicare_advantage | medicaid | commercial
general = national only, even if state is sent
Point-in-time (YYYY-MM-DD)
Maximum number of records to return.
Required range:
1 <= x <= 200Response
Successful Response