CMS — Centers for Medicare & Medicaid Services

CMS Medicare Coverage Database API

The Medicare Coverage Database (MCD) exposes National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), Local Coverage Articles, Proposed Decisions, National Coverage Analyses, and Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) records. Powers coverage policy lookups by HCPCS code, ICD-10, contractor jurisdiction, and state.

CMS Medicare Coverage Database API is one of 10 APIs that CMS — Centers for Medicare & Medicaid Services publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

This API exposes 1 machine-runnable capability that can be deployed as REST, MCP, or Agent Skill surfaces via Naftiko.

Tagged areas include Healthcare, Medicare, Coverage, Policy, and LCD. The published artifact set on APIs.io includes API documentation, an OpenAPI specification, and 1 Naftiko capability spec.

GitHub OpenAPI

Documentation

📖
Documentation
https://www.cms.gov/medicare-coverage-database/reports/reports.aspx

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/cms-gov/refs/heads/main/openapi/cms-gov-mcd-openapi.yml

Other Resources

🔗
Portal
https://www.cms.gov/medicare-coverage-database/
🔗
NaftikoCapability
https://raw.githubusercontent.com/api-evangelist/cms-gov/refs/heads/main/capabilities/medicare-coverage-database.yaml

OpenAPI Specification

cms-gov-mcd-openapi.yml Raw ↑ 
openapi: 3.0.3
info:
  title: CMS Medicare Coverage Database API
  description: |
    The Medicare Coverage Database (MCD) exposes National Coverage Determinations (NCDs),
    Local Coverage Determinations (LCDs), Local Coverage Articles, Proposed Decisions,
    National Coverage Analyses, and MEDCAC records.
  version: '1.0'
  license:
    name: Public Domain (U.S. Government Work)
    url: https://www.usa.gov/government-works
servers:
- url: https://www.cms.gov/medicare-coverage-database/api
  description: Production
paths:
  /ncds:
    get:
      summary: Search National Coverage Determinations
      operationId: searchNCDs
      tags: [NCD]
      parameters:
      - { name: keyword, in: query, schema: { type: string } }
      - { name: hcpcsCode, in: query, schema: { type: string } }
      - { name: status, in: query, schema: { type: string, enum: [active, retired, pending] } }
      responses:
        '200': { description: Matching NCDs }
  /ncds/{ncdId}:
    get:
      summary: Get NCD
      operationId: getNCD
      tags: [NCD]
      parameters:
      - { name: ncdId, in: path, required: true, schema: { type: string } }
      responses: { '200': { description: NCD record } }
  /lcds:
    get:
      summary: Search Local Coverage Determinations
      operationId: searchLCDs
      tags: [LCD]
      parameters:
      - { name: keyword, in: query, schema: { type: string } }
      - { name: state, in: query, schema: { type: string } }
      - { name: contractor, in: query, schema: { type: string } }
      - { name: hcpcsCode, in: query, schema: { type: string } }
      responses: { '200': { description: Matching LCDs } }
  /lcds/{lcdId}:
    get:
      summary: Get LCD
      operationId: getLCD
      tags: [LCD]
      parameters:
      - { name: lcdId, in: path, required: true, schema: { type: string } }
      responses: { '200': { description: LCD record } }
  /articles:
    get:
      summary: Search Coverage Articles
      operationId: searchArticles
      tags: [Articles]
      parameters:
      - { name: keyword, in: query, schema: { type: string } }
      - { name: state, in: query, schema: { type: string } }
      responses: { '200': { description: Matching articles } }
  /medcac:
    get:
      summary: Search MEDCAC Meetings
      operationId: searchMedcac
      tags: [MEDCAC]
      responses: { '200': { description: MEDCAC meeting records } }