procedure-coverage
Medicare coverage and fee-schedule amounts for CPT/HCPCS codes against a diagnosis
¿Debería usar esto?
Calidad y seguridad
Basado en el análisis automatizado de las definiciones de herramientas y el cumplimiento del protocolo.
Costo de contexto
Este es el número aproximado de tokens que se consumen cada vez que las herramientas del servidor se cargan en el contexto de un modelo. Los recuentos más altos reducen la atención disponible para otras tareas.
Instalar
Instalación con un clic
Agrega esto a tu archivo `claude_desktop_config.json`:
{
"mcpServers": {
"procedure-coverage": {
"url": "https://medicalclaim.ai/mcp"
}
}
}Puntos de conexión remotos
https://medicalclaim.ai/mcpstreamable-httpQué puede hacer
Inventario de herramientas
Herramientas (1)
🟢medicare_procedure_coverage(diagnosis, codes)
For a diagnosis and one or more CPT/HCPCS codes, report what CMS Local Coverage Articles record for each code, which ICD-10 diagnoses those articles list as covered or non-covered, and the CMS Physician Fee Schedule PROFESSIONAL amount where a national rate exists. Setting matters and is stated: codes performed only in a facility return not_applicable_in_this_setting rather than an invented office price, and codes CMS does not pay under the PFS (status I, X, N, E, B, P) return not_payable_under_pfs rather than a figure computed from published RVUs. Coverage is contractor-specific. Does NOT compare clinical effectiveness or recommend treatment, and a missing national rate is never treated as non-coverage. The amount is the clinician fee only — not the facility fee, device or imaging.
Esquema de entrada
{
"type": "object",
"properties": {
"diagnosis": {
"type": "string",
"description": "ICD-10 code or prefix, e.g. \"M17\" (knee osteoarthritis)"
},
"codes": {
"type": "string",
"description": "Comma-separated CPT/HCPCS codes, e.g. \"27447,20610\""
}
},
"required": []
}Comunidad
Evidencia