mcp-medicare-coverage

mcp-medicare-coverage

Enables searching and retrieving Medicare coverage policies including National and Local Coverage Determinations, National Coverage Analyses, and recent CMS coverage changes.

Category
Visit Server

README

mcp-medicare-coverage

Medicare coverage policy from CMS: national and local coverage determinations, plus open analyses

Part of Pipeworx — an MCP gateway connecting AI agents to 1366+ live data sources.

Tools

Tool Description
medicare_ncd_search Search current Medicare National Coverage Determinations (NCDs) by title, benefit category, or NCD number. NCDs describe national Medicare policy; they are not individualized coverage guarantees or medical advice.
medicare_ncd_detail Retrieve one official Medicare National Coverage Determination by CMS document ID and optional version, including covered indications, limitations, effective dates, benefit category, and revision text.
medicare_lcd_search Search current final Medicare Local Coverage Determinations (LCDs), optionally restricted to a state. LCDs are contractor- and jurisdiction-specific and can differ across locations.
medicare_lcd_detail Retrieve one Medicare LCD by document ID and version. Detailed LCD text requires a CMS license-agreement bearer token because documents may contain licensed AMA/ADA/AHA material; pass _licenseToken obtained directly from CMS after accepting those terms.
medicare_nca_search Search National Coverage Analyses (NCAs) and Coverage Analyses for Labs (CALs), including open and completed CMS evidence reviews. An open analysis is a policy process, not a coverage decision.
medicare_nca_detail Retrieve one CMS National Coverage Analysis by document ID, including request, issue, benefit category, dates, decision memo, and public-comment status when supplied by CMS.
medicare_recent_coverage_changes Recently published or updated national Medicare coverage documents from CMS, including NCDs, NCAs, CALs, MEDCAC meetings, and technology assessments.
medicare_coverage_states List CMS Coverage API state identifiers used to scope local Medicare coverage searches.

Quick Start

Add to your MCP client (Claude Desktop, Cursor, Windsurf, etc.):

{
  "mcpServers": {
    "medicare-coverage": {
      "url": "https://gateway.pipeworx.io/medicare-coverage/mcp"
    }
  }
}

Or connect to the full Pipeworx gateway for access to all 1366+ data sources:

{
  "mcpServers": {
    "pipeworx": {
      "url": "https://gateway.pipeworx.io/mcp"
    }
  }
}

Using with ask_pipeworx

Instead of calling tools directly, you can ask questions in plain English:

ask_pipeworx({ question: "your question about Medicare Coverage data" })

The gateway picks the right tool and fills the arguments automatically.

More

License

MIT

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