MCP server

Medicare Coverage

io.github.pipeworx-io/medicare-coverage

Checked 26 Oct 2026, 08:29 UTC · Connected to it and listed its tools

MCP server for medicare-coverage

Website Source

At a glance

Type

MCP server

Publisher

pipeworx.io (verified by the MCP Registry)

Status

Working at last check

Tools

69

Token cost

About 31,475 tokens per request

Sets up in

Claude Code, Claude Desktop, Codex, Gemini CLI, Cursor, VS Code, Antigravity, ChatGPT, OpenAI API, Grok

Last checked

26 Oct 2026, 08:29 UTC

Connect it to your agent

Add to CursorAdd to VS CodeVS Code Insiders

Opens the app, which shows the server and asks you to confirm. For other apps, copy the setup below.

Claude Code

claude mcp add --transport http medicare-coverage https://gateway.pipeworx.io/medicare-coverage/mcp

Claude Desktop

Settings → Connectors → Add custom connector, and paste the URL.

Codex (config.toml)

[mcp_servers.medicare-coverage]
url = "https://gateway.pipeworx.io/medicare-coverage/mcp"

Gemini CLI

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

Cursor

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

VS Code

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

Antigravity

agy mcp add medicare-coverage https://gateway.pipeworx.io/medicare-coverage/mcp

ChatGPT

Settings → Apps & Connectors → Advanced settings: turn on Developer mode, then Create a connector and paste the URL. Which plans can do this varies.

OpenAI API (Responses tools)

{"type":"mcp","server_label":"medicare-coverage","server_url":"https://gateway.pipeworx.io/medicare-coverage/mcp","require_approval":"always"}

Grok (xAI API tools)

{"type":"mcp","server_label":"medicare-coverage","server_url":"https://gateway.pipeworx.io/medicare-coverage/mcp"}

Tools

• medicare_article_code_profile ~216 tokens
  Retrieve one CMS Medicare Coverage Article with its CPT/HCPCS codes and contractor records. Licensed AMA/ADA/AHA content requires a caller-provided CMS license token. Code inclusion describes billing guidance, not guaranteed coverage or payment.
• medicare_coverage_states ~59 tokens
  List CMS Coverage API state identifiers used to scope local Medicare coverage searches.
• medicare_coverage_timeline ~543 tokens
  Retrieve official CMS version or revision history for a Medicare NCD, NCA, CAL, or LCD. Accepts either identifier CMS publishes for a coverage document: the public one that appears in the policy text and in every citation of it — an NCD section number such as 310.1 or 90.2, an NCA/CAL tracking numbe
• medicare_dme_service_trend ~144 tokens
  Show annual national Medicare fee-for-service DME supplier, beneficiary, claim, service, and average-payment metrics for one HCPCS code. It excludes Medicare Advantage and is not total market demand or company revenue.
• medicare_dme_supplier_market ~165 tokens
  Return a bounded API-order sample of Medicare fee-for-service DME supplier rows for an exact HCPCS code and year, optionally filtered by state, with the authoritative matching-row count. This is not a supplier ranking or total market size.
• medicare_enrollment_trend ~158 tokens
  Show annual Medicare enrollment and Medicare Advantage/other, Original Medicare, Part D PDP, Part D MA-PD, and dual-eligible counts nationally or for one state. Enrollment counts are program participation, not utilization or revenue.
• medicare_hcpcs_geography ~154 tokens
  Compare state-level Medicare fee-for-service provider, beneficiary, service, and average-payment metrics for one HCPCS code and program year. State beneficiary counts across places of service must not be summed as unique people.
• medicare_hcpcs_utilization_trend ~159 tokens
  Show annual Medicare Physician & Other Practitioners national utilization and payment metrics for one HCPCS code. Claims are fee-for-service aggregates with suppression and methodology limits; they do not measure total US use, coverage, demand, or company revenue.
• medicare_hospital_service_trend ~189 tokens
  Show annual national Medicare fee-for-service utilization and average-payment trends for one inpatient MS-DRG or outpatient APC using CMS geography/service aggregates. Trends exclude Medicare Advantage and do not measure total market demand, revenue, or profitability.
• medicare_inpatient_drg_market ~162 tokens
  Return a bounded sample of hospital-level Medicare fee-for-service inpatient rows for an exact MS-DRG and year, optionally filtered by state, with the authoritative matching-row count. Average payments are not hospital revenue or margin.
• medicare_lcd_detail ~179 tokens
  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_lcd_search ~267 tokens
  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_local_coverage_variation ~189 tokens
  Compare final LCD search matches across 1–15 states and Medicare Administrative Contractors. Different matching document counts or titles are policy signals, not proof of unequal beneficiary access or payment.
• medicare_nca_detail ~114 tokens
  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_nca_search ~156 tokens
  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_ncd_detail ~155 tokens
  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_ncd_search ~283 tokens
  ANSWERS "does Medicare cover X" / "is X covered by Medicare" / "what is Medicare's coverage policy for X" — searches current Medicare National Coverage Determinations (NCDs), the national policy documents that say whether Medicare covers a drug, device, procedure or therapy. Search by everyday produ
• medicare_outpatient_apc_market ~167 tokens
  Return a bounded sample of hospital-level Medicare fee-for-service outpatient rows for an exact APC and year, optionally filtered by state, with the authoritative matching-row count. APC payments are claims aggregates, not hospital revenue or margin.
• medicare_part_d_drug_spending ~155 tokens
  Search CMS Medicare Part D spending by brand or generic name and return 2020–2024 spending, claims, beneficiaries, dosage units, and unit-cost trends. Gross Part D spending is not manufacturer revenue, net price, profit, prescriptions, or total US sales.
• medicare_part_d_generic_competition ~156 tokens
  Profile Medicare Part D brand rows sharing an exact generic name, including CMS’s reported manufacturer count and 2020–2024 spending/use trends. Manufacturer count is a CMS aggregate, not a list of companies, products on market, or market share.
• medicare_part_d_prescriber_exposure ~223 tokens
  Return a bounded sample of Medicare Part D prescriber-by-drug rows for an exact brand name in one year, optionally filtered by state, with the authoritative matching-row count. This is not a prescriber ranking and suppressed/non-Part-D activity is absent.
• medicare_part_d_top_drugs ~210 tokens
  Rank Medicare Part D drugs by total gross spending for a year — the biggest drugs in the Part D program, highest first. Answers "which drugs have the highest Medicare Part D spending", "top Part D drugs by cost", "what does Medicare spend the most on". Returns brand name, generic name and total spen
• medicare_post_acute_provider_market ~185 tokens
  Return a bounded API-order sample of Medicare post-acute provider rows for home health, hospice, or skilled nursing in one year and optional state, with the authoritative matching-row count. Payments are not provider revenue or margin.
• medicare_post_acute_trend ~167 tokens
  Show annual national Medicare fee-for-service beneficiaries, stays, service days, and payments for home health, hospice, or skilled nursing. Program definitions and year basis differ by service and the figures are not provider revenue.
• medicare_product_market_profile ~293 tokens
  UTILIZATION ANALYTICS for a product whose HCPCS billing codes you ALREADY KNOW: requires 1-5 caller-supplied HCPCS codes and combines their annual Medicare fee-for-service claim volumes and payments with matching coverage-policy documents. Use when you have the codes and want spend, volume and trend
• medicare_provider_exposure ~178 tokens
  Return a bounded sample of provider-level Medicare fee-for-service rows for one HCPCS code, optionally filtered by state, with the authoritative matching-row count. This is not a provider ranking and excludes suppressed/non-FFS activity.
• medicare_recent_coverage_changes ~146 tokens
  Recently published or updated national Medicare coverage documents from CMS, including NCDs, NCAs, CALs, MEDCAC meetings, and technology assessments.

Browse

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