Spec Driven Development
MCP Server that facilitates spec-driven development workflows, not just Vibe Coding.
คำอธิบายจากผู้ทำ (ภาษาอังกฤษตามต้นฉบับ)
What does Medicare PAY — physician fee schedule, lab rates, and per-day unit limits.
สามเรื่องนี้ไม่รวมเป็นคะแนนเดียว เพราะความเห็น การวัด และความนิยม เป็นคนละเรื่องกัน
ตัวนี้ยังไม่ได้เรียบเรียงเป็นภาษาไทย ด้านล่างคือข้อเท็จจริงที่เราอ่านจาก registry
เลือกโปรแกรม AI ที่คุณใช้ แล้วคัดลอกค่าตั้งไปวาง
PIPEWORX_API_KEYค่าที่ติดป้ายความลับคือกุญแจของบัญชีคุณ อย่าส่งให้ใคร และอย่าวางในแชต
ต้องเตรียมก่อน
คุณใช้แอปไหน
เลือกแอปด้านบน เราจำไว้ให้ ครั้งหน้าปุ่มจะขึ้นว่า “ติดตั้งลง …”
ใช้ได้ทั้ง Claude บนเว็บ แอปคอมพิวเตอร์ และมือถือ:
https://gateway.pipeworx.io/medicare-pricing/mcpเปิด Claude Desktop → Settings → Developer → Edit Config แล้ววางค่านี้ในไฟล์ claude_desktop_config.json
{
"mcpServers": {
"medicare-pricing": {
"command": "npx",
"args": [
"-y",
"@pipeworx/mcp-medicare-pricing"
],
"env": {
"PIPEWORX_API_KEY": "ใส่ค่าของคุณ"
}
}
}
}พิมพ์คำสั่งนี้ใน Terminal
claude mcp add --transport http medicare-pricing https://gateway.pipeworx.io/medicare-pricing/mcpclaude mcp add medicare-pricing --env PIPEWORX_API_KEY='ใส่ค่าของคุณ' -- npx -y @pipeworx/mcp-medicare-pricingเติมค่าที่เว้นว่างไว้ก่อนรัน
วางในไฟล์ .cursor/mcp.json ของโปรเจกต์ หรือ ~/.cursor/mcp.json
{
"mcpServers": {
"medicare-pricing": {
"url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
}
}
}วางในไฟล์ .cursor/mcp.json ของโปรเจกต์ หรือ ~/.cursor/mcp.json
{
"mcpServers": {
"medicare-pricing": {
"command": "npx",
"args": [
"-y",
"@pipeworx/mcp-medicare-pricing"
],
"env": {
"PIPEWORX_API_KEY": "ใส่ค่าของคุณ"
}
}
}
}เบราว์เซอร์จะถามก่อนเปิดแอป จากนั้นแอปแสดงค่าตั้งให้ตรวจแล้วกดยืนยัน ช่อง key เว้นว่างไว้ให้คุณใส่เอง
วางในไฟล์ .vscode/mcp.json ของโปรเจกต์
{
"servers": {
"medicare-pricing": {
"type": "http",
"url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
}
}
}วางในไฟล์ .vscode/mcp.json ของโปรเจกต์
{
"servers": {
"medicare-pricing": {
"type": "stdio",
"command": "npx",
"args": [
"-y",
"@pipeworx/mcp-medicare-pricing"
],
"env": {
"PIPEWORX_API_KEY": "ใส่ค่าของคุณ"
}
}
}
}เบราว์เซอร์จะถามก่อนเปิดแอป จากนั้นแอปแสดงค่าตั้งให้ตรวจแล้วกดยืนยัน ช่อง key เว้นว่างไว้ให้คุณใส่เอง
ChatGPT ต่อได้เฉพาะ server ที่อยู่บนอินเทอร์เน็ต:
https://gateway.pipeworx.io/medicare-pricing/mcpชื่อเมนูอาจต่างกันเล็กน้อยตามแพ็กเกจและรุ่นของแอป
ตัวเลือกเก็บในคุกกี้บนเครื่องนี้ ไม่ต้องมีบัญชี
ค่าตั้งนี้สร้างจากข้อมูลใน registry ของผู้ทำ ถ้าไม่ตรงกับ README ให้เชื่อ README
ชื่อและคำอธิบายเครื่องมือตามที่ server ตอบมาเมื่อ 6 พ.ย. 2569 ผู้ทำเป็นคนเขียน ไม่ใช่เรา แสดงเป็นข้อความล้วน
ask_pipeworxPREFER 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_betaBeta version of ask_pipeworx: identical universal router (same 7,176 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_groundedHallucination-resistant answer mode for high-stakes reads. Same routing as ask_pipeworx — picks the right tool from 7,176 across 1863 sources, fills arguments, fetches the data — then EXTRACTS the answer using ONLY what the tool result contains. Returns {answer, evidence (verbati
search_withinSemantic 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_researchACCOUNT 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 1863 STRUCTURED data sources (SEC filings,
discover_toolsFind 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
subscribeCreate 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
unsubscribeCancel 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_subscriptionsList 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_alertsPull 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_factsTYPED, 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_searchSearch 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_dependencyComposite "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_researchResearch 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_arbitrageFind 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_edgesScan 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_spreadCross-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_riskRealizable-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_trackerEdge 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_edgePrices 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_auditExtract 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_diffField-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_marketsJOIN 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_calibrationREALIZED 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_compareThe 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_rateHow 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_evidenceWhat 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_compareWhat 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_rowClaygent-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_rowCheap 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_trendingWhat 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_questionsWhat 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_txtGenerate 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_checkProbe 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_presenceCompare 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_feedbackTell 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
rememberSave 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
recallRetrieve 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
forgetDelete 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_paymentWhat 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_rateWhat 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_lookupResolve 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_rateWhat 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_rateWhat 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_limitHow 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_pairCan 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_editWhat 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_rateWhat 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_lookupWhat 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_gafWhat 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_pricing_coverageWhat 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
เราตรวจจากข้อมูลที่ใครก็เปิดดูได้ ยังไม่ได้อ่านโค้ด ข้อที่ไม่เกี่ยวกับตัวนี้ไม่นับในตัวหาร · ตรวจเมื่อ 9 พ.ย. 2569
ชื่อใน registry ยืนยันด้วยบัญชี GitHub pipeworx-io ซึ่งเป็นเจ้าของ repo
ยังไม่ได้อ่านข้อมูล repo จาก GitHub
ยังไม่ได้อ่านข้อมูล repo จาก GitHub
ตอบกลับใน 284 ms (HTTP 200)
ไม่ต้องล็อกอิน
อ่านคำอธิบายเครื่องมือ 56 ตัวแล้ว ไม่พบคำสั่งแอบแฝงถึง AI
เทียบกับทุก server ที่ยังใช้งานในหมวดนี้ทั้งทะเบียน ดาวนับเฉพาะเมื่อผู้ลงทะเบียนเป็นเจ้าของ repo
จากการตรวจเบื้องต้นของเรา ผ่าน 3 จาก 3 ข้อที่ตรวจได้ เรายังไม่ได้อ่านโค้ด ก่อนใส่กุญแจหรือ token ให้ดูว่า server ขอสิทธิ์อะไร และเลือกกุญแจที่ทำได้เท่าที่จำเป็น
ต้องใส่ค่าเหล่านี้: PIPEWORX_API_KEY
ได้ทั้งสองแบบ จะลงในเครื่องหรือต่อผ่านคลาวด์ก็ได้
repo บน GitHub มีการแก้โค้ดล่าสุด – และส่งรุ่นล่าสุด (0.2.1) เข้า registry 6 วันที่ผ่านมา
โปรแกรมที่รองรับ MCP เช่น Claude Desktop, Claude Code, Cursor และ VS Code ตัวนี้ต่อผ่าน URL จึงใช้กับโปรแกรมที่รับ remote MCP ได้ เช่น ChatGPT ที่เปิดโหมดนักพัฒนา
ในหมวดเดียวกันมี Spec Driven Development, Remote Desktop Commander, SwarmMemo
server หมวดเดียวกันจากผู้ทำคนอื่น เรียงตามดาว
อ่านการ์ด:↓ ดาวน์โหลดต่อสัปดาห์i★ ดาว GitHubiสามเสา: รีวิว · ผลตรวจ · การใช้งานiอัปเดต = วันที่ส่งรุ่นล่าสุดเข้า registryi
MCP Server that facilitates spec-driven development workflows, not just Vibe Coding.
Remote Desktop Commander: use files, terminal and processes on your own computers from any AI app.
Talk with agent swarms: rooms, private messages and paid tasks for AI agents
ส่วนนี้คัดจาก repo ของผู้ทำตามต้นฉบับ PopNx MCP ไม่ได้ตรวจหรือรับรองเนื้อหา ตัด HTML รูปภาพ และสคริปต์ออกแล้ว ลิงก์จะพาออกนอกเว็บ
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.
| Tool | Answers |
|---|---|
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_coverage | Which vintages are loaded, including the PTP baseline vintage. |
None. No key, no account.
All from CMS, all downloadable files with no API:
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).
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".
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:
medicare-coverage handles it).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:
src/adlt.ts, below).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.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.
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.
Medicare pays by geographic locality. California alone has nine. The same office visit (99213, 2026) pays:
| Locality | Non-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.
`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.
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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