프로토타입 · 미리 보기: 공식 레지스트리의 모든 서버를 담고 있으며 30분마다 동기화해요. Google로 로그인하면 리뷰를 쓸 수 있어요.
PopNx MCPAI를 쓰는 사람을 위한 MCP 서버 · 쉬운 말로 설명해요

Medicare Pricing

제작자: pipeworx-io버전 0.2.1i★ 0i컴퓨터 또는 클라우드
레지스트리 이름io.github.pipeworx-io/medicare-pricing

설치 방법

What it does

What does Medicare PAY — physician fee schedule, lab rates, and per-day unit limits.

  • Connects 컴퓨터 또는 클라우드
  • Account or key Cloud: No key needed · Local: Needs PIPEWORX_API_KEY
  • Category 기타

설치

쓰고 있는 AI 앱을 고른 다음 설정을 복사하세요.

검사 4/4 통과 · 내가 묻는 내용은 제작자 서버(gateway.pipeworx.io)를 거쳐요

먼저: 어떤 AI를 쓰시나요?

쓰는 앱을 고르면 아래에 단계가 나옵니다.

Claude에 연결할 수 있어요 · 약 2분

키 필요 없음, 설치 필요 없음 · claude.ai나 데스크톱 앱에서 한 번 설정하면 채팅에서 쓸 수 있어요 · 무료 계정은 1개까지 · Team/Enterprise는 소유자(Owner)가 추가

  1. Claude의 Connectors 페이지 열기

    CustomizeConnectors

    CustomizeConnectors1+ Add2https://…3Add4
  2. “+ Add” → “Add custom connector”를 누르고 이 2칸 채우기

    여기서 복사해 Claude의 같은 이름 칸에 붙여 넣고 Continue를 누르세요

    Name · 이름Medicare Pricing
    Remote MCP server URL · 주소https://gateway.pipeworx.io/medicare-pricing/mcp

    Authentication은 Claude가 찾은 그대로 두고 Add를 누르세요

  3. 채팅에서 켜기

    +ConnectorsMedicare Pricing

  4. 해 보기

    Medicare Pricing을 써서 나에게 무엇을 해 줄 수 있는지 알려 주고, 하나 해 봐

    ✓ Claude가 Medicare Pricing을 쓰고 있다고 하거나 답에 Medicare Pricing 도구 이름이 나오면 연결된 거예요

메뉴 이름은 2026년 11월 11일에 Anthropic 도움말에서 확인 · 앱 버전에 따라 화면이 조금 다를 수 있어요

ChatGPT는 기업용 요금제에서만 연결돼요

웹의 ChatGPT Business, Enterprise, Edu에서 워크스페이스 관리자나 소유자가 추가해요 · Free, Plus, Pro를 쓰면: 내 ChatGPT 요금제로는 아직 MCP를 직접 연결할 수 없어요

  1. 웹 ChatGPT에서 MCP 추가 페이지 열기

    Plugins+Add custom MCP server

    ChatGPTPlugins1+2https://…3Create4
  2. 이름과 주소 입력

    이름을 넣고 Connection에 주소를 붙여 넣은 뒤 경고에 체크하고 Create as a plugin을 누르세요

    Name · 이름Medicare Pricing
    Connection · 주소https://gateway.pipeworx.io/medicare-pricing/mcp
  3. 채팅에서 Medicare Pricing 고르기

    새 채팅을 열고 입력 전에 플러그인 목록에서 Medicare Pricing을 고르세요

  4. 해 보기

    Medicare Pricing을 써서 나에게 무엇을 해 줄 수 있는지 알려 주고, 하나 해 봐

    ✓ ChatGPT가 Medicare Pricing을 쓰고 있다고 하거나 답에 Medicare Pricing 도구 이름이 나오면 연결된 거예요

메뉴 이름은 2026년 11월 11일에 OpenAI 도움말에서 확인 · 앱 버전에 따라 화면이 조금 다를 수 있어요

Claude Code에 연결할 수 있어요 · 약 2분

키 필요 없음, 설치 필요 없음

  1. 터미널 열기

    Mac: Command+스페이스를 누르고 Terminal 입력 · Windows: PowerShell 열기

  2. 이 명령을 붙여 넣고 Enter

    claude mcp add --transport http --scope user medicare-pricing https://gateway.pipeworx.io/medicare-pricing/mcp
  3. Claude Code에서 /mcp 입력

    Medicare Pricing이 목록에 있고 연결됨으로 보이면 돼요

  4. 해 보기

    Medicare Pricing을 써서 나에게 무엇을 해 줄 수 있는지 알려 주고, 하나 해 봐

    ✓ Claude Code가 Medicare Pricing을 쓰고 있다고 하거나 답에 Medicare Pricing 도구 이름이 나오면 연결된 거예요

메뉴 이름은 2026년 11월 11일에 Anthropic 도움말에서 확인 · 앱 버전에 따라 화면이 조금 다를 수 있어요

Cursor에 연결할 수 있어요 · 약 2분

키 필요 없음, 설치 필요 없음

  1. 이 버튼으로 Cursor 열기

    Cursor에서 열기

    Cursor가 설치를 확인하면 Install을 누르세요

  2. Cursor에서 AI 채팅을 Agent 모드로 열기

  3. 해 보기

    Medicare Pricing을 써서 나에게 무엇을 해 줄 수 있는지 알려 주고, 하나 해 봐

    ✓ Cursor가 Medicare Pricing을 쓰고 있다고 하거나 답에 Medicare Pricing 도구 이름이 나오면 연결된 거예요

메뉴 이름은 2026년 11월 11일에 Cursor 도움말에서 확인 · 앱 버전에 따라 화면이 조금 다를 수 있어요

VS Code에 연결할 수 있어요 · 약 2분

키 필요 없음, 설치 필요 없음

  1. 이 버튼으로 VS Code 열기

    VS Code에서 열기

    VS Code가 설치를 확인하면 Install을 누르세요

  2. VS Code에서 AI 채팅을 Agent 모드로 열기

  3. 해 보기

    Medicare Pricing을 써서 나에게 무엇을 해 줄 수 있는지 알려 주고, 하나 해 봐

    ✓ VS Code가 Medicare Pricing을 쓰고 있다고 하거나 답에 Medicare Pricing 도구 이름이 나오면 연결된 거예요

메뉴 이름은 2026년 11월 11일에 VS Code 도움말에서 확인 · 앱 버전에 따라 화면이 조금 다를 수 있어요

Windsurf, Zed, Gemini CLI 같은 다른 MCP 앱은 추가 방법이 저마다 달라요. 앱 목록에서 확인하세요

MCP를 쓰는 앱 모두 보기 →

웹으로 연결하는 앱용 주소

주소https://gateway.pipeworx.io/medicare-pricing/mcp

JSON 설정은 아래 “개발자용”에 있어요

막혔나요? Medicare Pricing을 쓰는 사람에게 물어보세요💬 토론 →
개발자용: 터미널 명령과 JSON 설정

웹으로 연결

Claude Code

claude mcp add --transport http --scope user medicare-pricing https://gateway.pipeworx.io/medicare-pricing/mcp

Cursor (~/.cursor/mcp.json)

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

VS Code (mcp.json)

{
  "servers": {
    "medicare-pricing": {
      "type": "http",
      "url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
    }
  }
}

컴퓨터에 설치

Claude Code

claude mcp add --scope user medicare-pricing --env PIPEWORX_API_KEY=your-value -- npx -y @pipeworx/mcp-medicare-pricing

Claude Desktop (claude_desktop_config.json)

{
  "mcpServers": {
    "medicare-pricing": {
      "command": "npx",
      "args": [
        "-y",
        "@pipeworx/mcp-medicare-pricing"
      ],
      "env": {
        "PIPEWORX_API_KEY": "your-value"
      }
    }
  }
}

Cursor (~/.cursor/mcp.json)

{
  "mcpServers": {
    "medicare-pricing": {
      "command": "npx",
      "args": [
        "-y",
        "@pipeworx/mcp-medicare-pricing"
      ],
      "env": {
        "PIPEWORX_API_KEY": "your-value"
      }
    }
  }
}

VS Code (mcp.json)

{
  "servers": {
    "medicare-pricing": {
      "type": "stdio",
      "command": "npx",
      "args": [
        "-y",
        "@pipeworx/mcp-medicare-pricing"
      ],
      "env": {
        "PIPEWORX_API_KEY": "your-value"
      }
    }
  }
}

직접 입력할 값

  • PIPEWORX_API_KEY 비밀 env
    Optional Pipeworx API key. Without it calls are anonymous and capped daily; a free key raises the cap.

이 설정은 제작자의 레지스트리 정보로 만들었어요. README와 다르면 README를 따르세요.

한눈에 보기

주간 다운로드i
467/주
라이선스i
라이선스 표시 없음
연결 방식
컴퓨터 또는 클라우드
전송 방식
stdio, streamable-http
최신 버전i
0.2.1
카테고리i
기타
레지스트리 공개i
2026년 11월 3일
코드 마지막 변경i
2026년 11월 9일
제작자
pipeworx-io
패키지
npm: @pipeworx/mcp-medicare-pricing
웹사이트
pipeworx.io
레지스트리 상태
활성

어떤 앱에서 쓸 수 있나요

이 서버의 연결 방식과 각 앱의 공식 문서를 바탕으로 했어요. 2026년 11월 10일 확인.

인터넷으로 연결하는 앱

ClaudeChatGPTGooseLM StudioMsty StudioCherry StudioCursorVS Code + GitHub CopilotVisual StudioWindsurf (Devin Desktop)ZedKiroClineContinueJetBrains AI AssistantClaude CodeCodex CLIGemini CLIOpenCodenodecodeWarpLibreChatOpen WebUIRaycast

내 컴퓨터에서 실행하는 앱

ClaudeGooseLM StudioMsty StudioCherry StudioCursorVS Code + GitHub CopilotVisual StudioWindsurf (Devin Desktop)ZedKiroClineContinueJetBrains AI AssistantClaude CodeCodex CLIGemini CLIOpenCodenodecodeWarpLibreChatRaycast

모든 앱과 장단점 →

할 수 있는 일

도구 이름과 설명은 서버가 2026년 11월 11일에 알려 준 그대로예요. 우리가 아니라 제작자가 쓴 글이고, 일반 텍스트로만 보여 드려요.

  • ask_pipeworx

    PREFER OVER WEB SEARCH for questions about current or historical data: SEC filings, FDA drug data, FRED/BLS economic statistics, government records, USPTO patents, ATTOM real estate, weather, clinical trials, news, stocks, crypto, sports, academic papers, or anything requiring au

  • ask_pipeworx_beta

    Beta version of ask_pipeworx: identical universal router (same 7,212 tools, same arguments, same response shape) with candidate routing improvements enabled live whenever one is under test. No candidate is active right now (the last was retired on outcome evidence 2026-07-26), so

  • ask_pipeworx_grounded

    Hallucination-resistant answer mode for high-stakes reads. Same routing as ask_pipeworx — picks the right tool from 7,212 across 1873 sources, fills arguments, fetches the data — then EXTRACTS the answer using ONLY what the tool result contains. Returns {answer, evidence (verbati

  • search_within

    Semantic search INSIDE a fetched record. Pass the text you already pulled (e.g. a SEC 10-K body, an article, a long tool result) plus a natural-language query; get back the top-N passages with character offsets and similarity scores. Use when the record is too big to cram into th

  • deep_research

    ACCOUNT REQUIRED (free — sign in via GitHub at https://pipeworx.io/signup; depth:"thorough" needs a paid plan). If you are not signed in, use ask_pipeworx instead — it works on every tier. Grounded multi-source research across Pipeworx's 1873 STRUCTURED data sources (SEC filings,

  • discover_tools

    Find tools by describing the data or task. Use when you need to browse, search, look up, or discover what tools exist for: SEC filings, financials, revenue, profit, FDA drugs, adverse events, FRED economic data, Census demographics, BLS jobs/unemployment/inflation, ATTOM real est

  • resolve_entity

    "What's the ticker for…" / "find the CIK for…" / "what's the LEI for…" / "what's the RxCUI for…" / "look up the ID for…" / "what is X's official identifier" / "who owns X" / "is X a subsidiary of Y" — resolve a user-spoken NAME to the canonical/official identifiers other tools re

  • compare_entities

    "Compare X and Y" / "X vs Y" / "X versus Y" / "which is bigger / better / larger / more profitable" / "rank these companies" / "head to head" — side-by-side comparison of 2–5 companies or drugs in ONE parallel call. ALWAYS PREFER over sequential single-pack lookups when comparing

  • subscribe

    Create a proactive monitoring subscription to a live-data event stream. Returns the new subscription id. Requires a Pipeworx OAuth account (anonymous + BYO cannot persist subscriptions). Supported types: "sec_8k" (8-K filings matching ticker + item codes — e.g. items:["5.02"] = o

  • unsubscribe

    Cancel a subscription by id. Ownership is enforced — you can only cancel your own subscriptions. The row is deactivated (not deleted) so its historical events stay available via recent_alerts.

  • list_subscriptions

    List the caller's active subscriptions. Returns id, type, params, created_at, last_fired_at, fire_count for each. Use this to review what you're monitoring before adding more or to find an id to cancel.

  • recent_alerts

    Pull fired events from your subscription feed. Returns the most recent alerts the evaluator has written to your persisted feed — each carries source, citation_uri (pipeworx:// when available), and the raw event payload. Filter by type (e.g. "sec_8k") and/or since (ISO timestamp).

  • entity_profile

    "Tell me about X" / "research Acme" / "brief me on Tesla" / "what does Apple do" / "company profile for Microsoft" / "give me the rundown on NVDA" / "everything you know about $TICKER" — full cross-source profile of a US public company in ONE parallel call. ALWAYS PREFER over cha

  • recent_changes

    "What's new with X" / "latest on Y" / "what happened to Z this week / month / quarter" / "updates on Acme" / "news on Tesla recently" / "what's happening with Apple" — change feed for a company in the last N days/weeks/months in ONE parallel call. Fans out to SEC EDGAR (filings s

  • validate_claim

    "Is it true that…" / "fact check" / "verify the claim that…" / "did X really…" / "was Y actually…" / "confirm or refute" / "true or false" — natural-language claim verification against authoritative sources. Use whenever the agent needs to check whether something a user said is f

  • company_facts

    TYPED, DETERMINISTIC financial facts for a US public company for an EXPLICITLY NAMED reporting period — "Apple revenue for fiscal 2023", "Walmart net income FY2026 Q3", "Microsoft cash at the end of fiscal 2024". PREFER OVER entity_profile / get_company_financials whenever the pe

  • company_register_search

    Search the NATIONAL BUSINESS REGISTERS by company name and get the register's own id back — a Companies House number, a Norwegian organisasjonsnummer, a Finnish business id, a SIREN, a Japanese corporate number, an Estonian registry code, a CNPJ, or an LEI. Use this when you want

  • scan_dependency

    Composite "should I add this npm package to my project" check in ONE call — fans out across deps.dev (license + advisories + version history) and bundlephobia (gzipped/minified bundle size, dependency count, ESM/tree-shake support). Use whenever an agent asks "is X safe / popular

  • bet_research

    Research a Polymarket bet by pulling the relevant Pipeworx data for it in one call. Pass a market slug ("will-kristi-noem-win-the-2028-republican-presidential-nomination"), a polymarket.com URL, or a question text. A dated slug ("...-by-june-30-2026") still resolves after it sett

  • polymarket_arbitrage

    Find arbitrage opportunities on Polymarket via monotonicity violations + partition-sum checks. Call with NO args for a `trending_scan` of the top ~200 markets by weekly volume; pass `event` for the strongest per-event partition_check, or `topic` for a themed cross-event scan. `ev

  • polymarket_edges

    Scan top Polymarket markets and return opportunities where Pipeworx data disagrees with market price. Built for "what should I bet on today" — agents discover opportunities without paging hundreds of markets. FIVE MODEL FAMILIES grouped into three response segments under by_segme

  • polymarket_kalshi_spread

    Cross-venue spread between Kalshi and Polymarket for the same resolving question. The two venues sometimes price the same outcome 2-25pp apart because their participant pools differ — when the bet shapes are equivalent that delta is a real signal, when they aren't the tool says s

  • polymarket_fill_risk

    Realizable-vs-theoretical edge check against live CLOB order-book depth — AND Polymarket's own taker fee, which is never zero and is folded in rather than left for you to add (fleet #3446: r/PredictionsMarkets flagged a "clean" fill that quietly omitted it as optimistic in the di

  • polymarket_edge_tracker

    Edge persistence and decay telemetry built from daily polymarket_edges snapshots. Answers "how long has this edge existed and is it shrinking?" — a fresh wide edge and a 3-week-old wide edge are different trades (the latter is wide for a reason nobody is willing to take). Args: d

  • kalshi_weather_edge

    Prices Kalshi daily high-temperature markets against the NWS forecast for the market's OWN settlement station, and measures whether that forecast actually beats the market. Two modes. LIVE (default): returns the full strike ladder for one city and settlement date with market_prob

  • resolution_audit

    Extract the settlement clause of a single Polymarket (.com or .us) or Kalshi market: who publishes the settling number (source), the clock time + timezone it is taken at (falling back to the market TITLE when the clause itself says "the time range specified in the title" — e.g. P

  • resolution_diff

    Field-by-field diff of TWO markets' settlement clauses (one from each of `a` and `b`; either can be Polymarket .com, Polymarket US, or Kalshi) — runs resolution_audit on both sides and compares source, settle time, precision, comparison_basis, and evidence standard. Returns `equi

  • release_calendar_markets

    JOIN of the official release calendar (econ data, the FOMC, FDA decisions, SEC rules) against LIVE Polymarket/Kalshi markets — which scheduled releases land in the next N hours, and which live markets resolve on them. This is a POSITIONING tool, not a speed product: results are c

  • prediction_calibration

    REALIZED win rate by shown price and minutes elapsed for short-horizon crypto up/down markets, net of taker fee — read from our own settled-outcomes archive, not from live prices. Answers the one question no venue will: "a side shown at 82 with five minutes left, how often did it

  • updown_venue_compare

    The same 15-minute crypto "up or down" window priced on polymarket.com, Polymarket US and Kalshi, side by side, with whether each pair is actually the same contract. Pass asset (btc | eth | sol | xrp | bnb) and window ("current" default, "next", "previous", or the window START as

  • updown_divergence_rate

    How often two venues settled the SAME 15-minute crypto window differently, over every settled window on record. Compares polymarket.com (Chainlink TWAP) with Kalshi and with Polymarket US (both CF Benchmarks BRTI), and Kalshi with Polymarket US as the same-feed control. Per pair:

  • archive_evidence

    What did a web page say on a given date? Finds the archived capture of a URL nearest that date across the Internet Archive Wayback Machine, Common Crawl and Arquivo.pt, reads it, and returns the readable text (HTML stripped) with the capture timestamp, a link to the archived copy

  • archive_compare

    What changed on a web page between two dates? Resolves the archived capture nearest each date (Internet Archive Wayback Machine, Common Crawl, Arquivo.pt), extracts the readable text of both, and returns a text-level diff: the segments removed and added, a similarity score, and b

  • research_row

    Claygent-style per-row research: answer ONE question about ONE company and return a JSON object matching your output_schema, with every field wrapped in its own evidence — {value, evidence_url, quote, status}. status is NEVER self-reported by the model: "found" means this code in

  • classify_row

    Cheap categorization: given a company and a list of candidate labels, decide which labels apply — the most common GTM/AI usage shape (tagging a list by industry, ICP fit, etc.), one small model call. Same evidence contract as research_row: each label comes back {label, applies, e

  • pipeworx_trending

    What other AI agents are calling on Pipeworx right now. Returns the top tools, top packs, and total call volume over a recent window (24h, 7d, or 30d). Useful for: (1) discovering what data sources are hot for current events, (2) confirming a popular tool is the canonical choice

  • suggest_questions

    What can I ask Pipeworx? / what is Pipeworx good for? / what can you do? / give me ideas / show me examples / getting started / what data do you have? — the onboarding entry point for an agent that just connected and wants to know what is worth asking. Returns category-bucketed e

  • generate_llms_txt

    Generate a production-ready llms.txt file for any URL so AI crawlers (ChatGPT, Claude, Perplexity) can index the site cleanly. Fetches the page, extracts title/description/key links, and emits the standard llms.txt markdown format. Output is a single text blob ready to drop at si

  • ai_visibility_check

    Probe one or more LLMs for what they know about a business / brand / product / topic and score visibility (0-100) per model. Default model is Workers AI Llama-3.3-70b (free); pass `_apiKey` to also probe Anthropic (BYO key — you pay Anthropic directly for those calls). Returns pe

  • scan_competitor_ai_presence

    Compare AI visibility across multiple entities side-by-side. Probes each entity (your brand + N competitors) with ai_visibility_check, ranks by score, surfaces which is most/least recognized. Useful for competitive AI-marketing audits: "does Claude know about us as well as our co

  • pipeworx_feedback

    Tell the Pipeworx team something is broken, missing, or needs to exist. Use when a tool returns wrong/stale data (bug), when a tool you wish existed isn't in the catalog (feature/data_gap), or when something worked surprisingly well (praise). ONLY for tools served by this Pipewor

  • remember

    Save data the agent will need to reuse later — across this conversation or across sessions. Use when you discover something worth carrying forward (a resolved ticker, a target address, a user preference, a research subject) so you don't have to look it up again. Stored as a key-v

  • recall

    Retrieve a value previously saved via remember, or list all saved keys (omit the key argument). Use to look up context the agent stored earlier — the user's target ticker, an address, prior research notes — without re-deriving it from scratch. Scoped to your identifier (anonymous

  • forget

    Delete a previously stored memory by key. Use when context is stale, the task is done, or you want to clear sensitive data the agent saved earlier. Pair with remember and recall.

  • medicare_physician_payment

    What does Medicare pay a doctor for a procedure code, in a specific place? Returns the relative value units (work, practice expense, malpractice) and the actual dollar payment for a HCPCS/CPT code, adjusted for the Medicare LOCALITY — payment varies geographically, not just by st

  • medicare_lab_rate

    What does Medicare pay for a laboratory test? Returns the national Clinical Laboratory Fee Schedule rate for a lab HCPCS/CPT code — lab tests are paid from their own national fee schedule rather than the physician schedule, so there is one rate and no locality adjustment. Answers

  • medicare_lab_test_lookup

    Resolve a branded molecular or genomic lab test by its commercial name (e.g. Signatera, Guardant360 CDx, FoundationOne CDx, FoundationOne Liquid CDx, Tempus xT CDx, DecisionDx-Melanoma, Envisia, Shield) to its CPT PLA / HCPCS billing code, the lab that runs it, what Medicare pays

  • medicare_dmepos_rate

    What does Medicare pay for a piece of durable medical equipment, prosthetic, orthotic, or medical supply (DMEPOS)? Returns the fee-schedule amount for a HCPCS Level II code (E/K/L/A-codes — CPAP machines, wheelchairs, ostomy supplies, braces, oxygen equipment...) in a given US st

  • medicare_opps_rate

    What does Medicare pay a HOSPITAL OUTPATIENT department for a procedure, device, or drug code? Returns the status indicator, Ambulatory Payment Classification (APC), relative weight, national payment rate, and beneficiary copayment for a HCPCS/CPT code under the Hospital Outpatie

  • medicare_code_units_limit

    How many units of a procedure code will Medicare pay for one patient in one day? Returns the NCCI Medically Unlikely Edit (MUE) — the maximum units allowed — with the adjudication indicator saying whether the limit is absolute or can be overridden with documentation, and the rati

  • check_code_pair

    Can two procedure codes be billed together on the same day? Checks the CMS National Correct Coding Initiative procedure-to-procedure (PTP) edit for a pair of HCPCS/CPT codes and returns the modifier indicator saying whether the pair can never be unbundled, can be unbundled with a

  • explain_ncci_edit

    What NCCI procedure-to-procedure edits exist for a single code? Lists the other codes this HCPCS/CPT code has a recorded PTP edit with — whether it is the code you bill (Column 1) or the one bundled into another (Column 2) — with each pair's modifier indicator. Answers "what code

  • medicare_fqhc_pps_rate

    What does Medicare pay a Federally Qualified Health Center (FQHC) per visit? Returns the CMS FQHC Prospective Payment System (PPS) national BASE payment rate for a calendar year — the figure CMS publishes once a year, before any per-FQHC Geographic Adjustment Factor (GAF) is appl

  • medicare_gpci_lookup

    What are the Medicare geographic adjustment indices (GPCIs) for a place — with NO procedure code needed? Returns the work, practice-expense and malpractice GPCI for a Medicare payment locality (or every locality in a state), for a calendar year. Answers "GPCI for Rest of Florida

  • medicare_fqhc_gaf

    What is the FQHC Geographic Adjustment Factor (GAF) for a place, and what does Medicare pay a Federally Qualified Health Center per visit THERE? Returns the official CMS FQHC PPS GAF for a Medicare locality and calendar year, and the GAF-adjusted per-visit rate (national base rat

  • medicare_hospital_wage_index

    What is the Medicare IPPS hospital wage index for a metro area (CBSA) and fiscal year? Returns the wage index CMS applies to hospital inpatient payment in a CBSA, with the GAF, the reclassified wage index, the value before frontier / rural-floor / imputed-floor adjustment, and wh

  • medicare_pricing_coverage

    What Medicare pricing data is loaded and how current it is: the fee-schedule years and quarters held, how many codes are in each dataset, how many localities, and the PTP pair-edit change window. Use to check a vintage is current enough to quote before relying on a rate, and to s

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제작자의 README

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medicare-pricing

What Medicare pays — physician fee schedule, lab rates, and per-day unit limits. The companion to medicare-coverage, which answers whether something is covered but not what it is worth.

Part of Pipeworx — an MCP gateway connecting AI agents to 1865+ live data sources. This is an independent, unofficial integration — not affiliated with, endorsed by, or published by the upstream provider.

Tools

ToolAnswers
medicare_physician_payment"How much does Medicare pay for 99213 in Los Angeles?" — RVUs and dollars, locality-adjusted.
medicare_lab_rate"What does a comprehensive metabolic panel reimburse?" — national CLFS rate.
medicare_lab_test_lookup"What does Medicare pay for Signatera, and which MolDX LCD applies?" — brand name → PLA code, current CLFS rate, and the MolDX LCDs/articles for the test's category.
medicare_dmepos_rate"How much does Medicare pay for a CPAP machine (E0601) in Texas?" — state-priced, rural vs non-rural.
medicare_opps_rate"What does Medicare pay a hospital outpatient department for CPT 33289 (CardioMEMS implant)?" — status indicator, APC, relative weight, national payment rate, copay, device/drug pass-through status.
medicare_code_units_limit"How many units of this code will they pay for in one day?" — NCCI MUE.
check_code_pair"Can I bill 00142 and 64474 together?" — NCCI PTP edit + modifier indicator for a code pair.
explain_ncci_edit"What is bundled into (or bundles into) this code?" — every recorded PTP edit for one code.
medicare_fqhc_pps_rate"What is the FQHC PPS base rate for 2026?" — CMS's national Federally Qualified Health Center per-visit base rate, by year.
medicare_pricing_coverageWhich vintages are loaded, including the PTP baseline vintage.

Auth

None. No key, no account.

Data sources

All from CMS, all downloadable files with no API:

  • Physician Fee Schedule relative value files (RVUs + GPCIs) — annual
  • Clinical Laboratory Fee Schedule — quarterly
  • DMEPOS fee schedule (durable medical equipment, prosthetics, orthotics, supplies) — quarterly (as necessary): A=Jan, B=Apr, C=Jul, D=Oct
  • OPPS Addendum B (Hospital Outpatient Prospective Payment System payment rates by HCPCS code) — quarterly: Q1=Jan, Q2=Apr, Q3=Jul, Q4=Oct
  • NCCI Medically Unlikely Edits — quarterly
  • NCCI PTP quarterly additions/deletions/revisions files — quarterly (see below — a narrower source than the other three)
  • FQHC Prospective Payment System base payment rate — annual (see below — a hand-maintained table, not a downloaded file)

FQHC PPS base payment rate — a hand-maintained table, and why

medicare_fqhc_pps_rate is different from the rest of this pack: it is not backed by Supabase or a downloaded bulk file, because there is neither. CMS publishes the FQHC PPS national base rate exactly once a year, as a single new dollar figure inside a CMS Manual System "Recurring Update Notification" Change Request PDF — one number, one PDF, once a year. Standing up an ingest pipeline for that is not proportionate, so the pack carries a small table of {year, base_rate_usd, effective_date, market_basket_update_pct, prior_year_rate_usd, transmittal, change_request, publication} in src/index.ts (FQHC_PPS_BASE_RATES), five rows (CY2022–CY2026), each read directly off its own primary CMS transmittal.

This is the national BASE rate only — before the per-FQHC Geographic Adjustment Factor (GAF) CMS applies on top. The GAF-adjusted amount for a locality is medicare_fqhc_gaf (below).

Geographic adjustment: medicare_gpci_lookup and medicare_fqhc_gaf (fleet #3398)

medicare_gpci_lookup returns the work / practice-expense / malpractice GPCIs for a locality or a whole state with no procedure code (years 2024-2026 loaded; 2024 and 2025 were backfilled with scripts/ingest-medicare-pricing.mjs --gpci-only). medicare_fqhc_gaf returns CMS's own published FQHC GAF per locality for CY2018-2026 (each year from CMS's own GAF publication for that year; 2018 uses CMS's February 2018 updated table, 2021 and 2020 the updated releases) and the GAF-adjusted per-visit rate (2022-2026; null for 2018-2021, whose national base rate is not carried). The GAF table is CMS's published number, not derived here, and is a small generated source file (src/fqhc-gaf.ts, 109-112 localities per year; ~50 KB). Refresh each January: download the new year's FQHC GAF file from CMS and run node scripts/build-fqhc-gaf-table.mjs 2018= ... 2026= 2027= (ascending; the script finds columns by header name because CMS's layout changes yearly).

Refresh: CMS issues the following year's transmittal in Nov/Dec (the CY2026 update was dated 2025-12-05 for a Jan 1, 2026 effective date). Add a row to FQHC_PPS_BASE_RATES each year once it posts — search CMS's own transmittals (Pub 100-04 Medicare Claims Processing, or Pub 100-02 Medicare Benefit Policy) for "FQHC PPS Calendar Year".

ADLT list — brand name to billing code

medicare_lab_test_lookup exists because callers name a test by its brand ("Signatera"), not its code ("0340U"), and nothing else in the catalog maps one to the other (fleet #2426).

Source, and why it is the only one. CMS's list of Advanced Diagnostic Laboratory Tests (https://www.cms.gov/files/document/advanced-diagnostic-laboratory-tests-under-medicare-clfs.pdf) gives code, lab, proprietary test name, approval date and initial-period payment for 18 tests. It is a US federal work (17 USC 105). The sources that were checked and rejected:

  • AMA PLA long-descriptor PDF — "CPT® Copyright 2026 American Medical Association. All rights reserved." It also lists only the codes changed in the latest cycles (143 of them), and 0340U is not among them.
  • Palmetto MolDX DEX registry — needs a registered account, even for the "public user" catalog, and hides Z-codes from public users. That's an auth wall.
  • CMS Coverage API article code tables — need a caller's CMS/AMA licence token (already how medicare-coverage handles it).
  • NCBI GTR — knows Signatera and Guardant360 but its cptcode field is empty for them.

That made coverage ADLT-only, and fleet #2458 measured the cost: Oncotype DX (81519, a Category I MAAA code, not an ADLT) routed here 5/5 and came back found: false. Resolution now runs through three sources in order:

  1. CMS ADLT list (src/adlt.ts, below).
  2. MAAA brand table (src/brand-codes.ts) -- non-ADLT branded tests whose proprietary name is tied to a code in CPT Appendix O and which each have a brand-named or category MolDX billing article on the CMS MCD (Oncotype DX breast/DCIS/colon/prostate, Prosigna, MammaPrint, EndoPredict, Breast Cancer Index, Cologuard, Prolaris, Decipher, Afirma, ConfirmMDx, 4Kscore). Only brand -> code -> lab FACTS are kept, never AMA descriptor text. Every code was checked to carry a CLFS rate on 2026-09-26. To add a row: confirm the pair in a public source, confirm medicare_lab_rate has a rate, and set coverage_topic to a phrase from a live MolDX article title.
  3. NCBI GTR, live -- where the performing lab registered a CPT code (e.g. Afirma -> 81546, Decipher -> 81542). Labelled lab-reported. Sparse: Oncotype DX and Signatera carry no code there, which is why it is last.

A test found in none returns found: false, reason: brand_not_found with sources_checked naming all three, and a pointer to medicare_lab_rate.

Copy, not proxy. The list is a two-page PDF with no API, and the gateway has no PDF parser, so the rows are baked into src/adlt.ts. The PDF's "Test Descriptor" column is AMA PLA text and is not copied. Every call sends a HEAD to the PDF and compares Last-Modified with the snapshot's. If CMS has republished, the response carries snapshot_current: false. To refresh: download the PDF, extract its text (pypdf works), update the rows in src/adlt.ts, and bump ADLT_DATA_AS_OF and SNAPSHOT_LAST_MODIFIED.

Coverage. Each test has a coverage_topic, a phrase that is ours and not CMS's. It matches the title of the MolDX LCD/article family for the test's category (for Signatera, "Minimal Residual Disease"). The tool reads the live, keyless CMS Coverage API reports and returns the active LCDs and billing articles with that title. Retired ones come back only with include_retired: true. This matters because contractors re-issue MolDX policies under new numbers: Noridian's L38816 and A58456 were retired 2026-02-05 and replaced by L38814 and A58454. Whether a specific test is listed is answered by the billing article's code table, not by the title match.

Vintage is not a detail

Fee schedules change annually and NCCI/CLFS quarterly. Quoting a 2026 procedure at 2024 rates is a wrong number with billing consequences, so every response states the year (and quarter where quarterly) it used, and sets year_was_defaulted when the caller did not name one. Asking for a year that is not loaded returns year_not_loaded rather than silently answering with a different year's rates.

Locality is not state

Medicare pays by geographic locality. California alone has nine. The same office visit (99213, 2026) pays:

LocalityNon-facility
Bakersfield, CA$99.52
Alabama$87.79

A 13% swing a state-shaped answer would hide. medicare_physician_payment resolves the locality explicitly, states what it resolved to, and lists other localities that matched so a caller can pick a different one.

Payment is computed with the real formula and the arithmetic is returned so it can be audited:

((work RVU × PW GPCI) + (PE RVU × PE GPCI) + (MP RVU × MP GPCI)) × conversion factor

Facility and non-facility are both given — a procedure pays less in a hospital because the facility bills its own fee separately.

Whether two codes can be billed together — the full PTP baseline

`check_code_pair` and `explain_ncci_edit` now cover the FULL NCCI procedure-to-procedure (PTP) edit baseline, not a rolling change window (fleet #1293, 2026-09-07). CMS distributes the complete PTP edit table behind an AMA CPT licence click-through (/license/ama?file=... on cms.gov). Bruce authorized accepting that licence on the company's behalf via the Needs Bruce dashboard (2026-09-07); the licence text was read in full before any data shipped — see "NCCI PTP licence" below for the quoted terms and the reasoning for why this pack's serving shape stays inside them.

Loaded: the 2026 Quarter 3 baseline (v322r0, effective 2026-07-01 — the newest vintage actually in effect; CMS had already posted Q4 2026 at ingest time, but that isn't effective until 2026-10-01 and using it would have answered today's queries with tomorrow's rules). The 8 baseline files (practitioner + hospital × 4 code-range splits each) hold 4,498,118 raw historical-episode rows — the same (column1, column2) pair can have several add/delete/re-add episodes over the years — collapsed to 4,109,749 distinct pairs by keeping each pair's open-ended (currently active) episode, or else its most recently closed one. The prior 2025q1..2026q3 quarterly change files are re-applied ON TOP of the baseline, in that order, so a pair the quarterly files recorded as deleted cannot be resurrected by an older baseline row.

A NOT-FOUND answer now means CMS has never recorded a PTP edit for that pair — not merely "no recorded change in this window", which was the scope limit before this fleet task. medicare_code_units_limit remains the separate units edit (one code, not a pair) and was never affected by this limit.

NCCI PTP licence

The CMS licence click-through (same boilerplate CMS uses across its whole AMA CPT-derived file family — the physician fee schedule, MUE, and PTP downloads all carry it) reads, in relevant part:

CPT codes, descrip

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