{
  "name": "medicare-coverage-mcp",
  "title": "HealthMesh · Medicare Coverage (NCD/LCD) MCP",
  "version": "0.1.1",
  "description": "Live Medicare coverage policy from the CMS Coverage API (Medicare Coverage Database): search National Coverage Determinations with full text, national coverage analyses, Local Coverage Determinations and billing & coding articles by keyword, state and MAC, compare LCDs across states, and list recent coverage changes. LCD/article full text and code lists (CPT) are not included (AMA/ADA/AHA license).",
  "healthmesh_domain": "Utilization Management",
  "datasets": [
    "UM-02"
  ],
  "mcp_endpoint": "https://medicare-coverage.healthmesh.ai/mcp",
  "transport": "Streamable HTTP (stateless, JSON responses)",
  "authorization": "none",
  "auth_mode": "off",
  "docs": "https://github.com/HendrikK/healthmesh/tree/main/servers/medicare-coverage-mcp#readme",
  "contact": "hendrik.kleine@gmail.com",
  "data_source": {
    "name": "CMS Coverage API (Medicare Coverage Database), Centers for Medicare & Medicaid Services",
    "url": "https://api.coverage.cms.gov/docs/",
    "license": "U.S. Government information, no key; license-gated LCD/article text and CPT/CDT/UB-04 code lists not used",
    "refresh": "live (6 h edge cache)"
  },
  "tools": [
    {
      "name": "coverage_search_ncds",
      "title": "Search National Coverage Determinations",
      "description": "Keyword search of all current Medicare National Coverage Determinations (NCDs, the national 'is it covered' rules in Pub. 100-03), matched against title and NCD number (e.g. 'acupuncture', 'oxygen', '20.4'). Returns NCD number, title, manual chapter, last-updated date and links. Optionally also searches national coverage analyses (NCAs) and coverage-with-evidence documents. Use coverage_get_document for the full text."
    },
    {
      "name": "coverage_search_lcds",
      "title": "Search Local Coverage Determinations and articles",
      "description": "Searches Medicare Local Coverage Determinations (LCDs, MAC-level coverage rules) and optionally billing & coding articles and proposed LCDs, by title keyword, state and status. Returns L/A number, title, MAC (contractor) and contract type, status, effective/retirement dates and the official MCD link. LCD/article text and code lists are not returned (CMS license gate); open the link."
    },
    {
      "name": "coverage_get_document",
      "title": "Get a Medicare coverage document",
      "description": "Returns one coverage document. NCD: full text sections (item/service description, indications and limitations, benefit category, cross references, reasons for denial, revision history) with effective dates. NCA: status, contacts and tracking info. LCD or billing & coding article: metadata (MAC, contract type, status, dates, states in the jurisdiction) and the official MCD link; the full text and code lists of LCDs/articles are behind a CMS license gate and are not returned."
    },
    {
      "name": "coverage_list_recent_changes",
      "title": "Recent Medicare coverage changes",
      "description": "Lists coverage documents CMS reports as new or revised: national (NCDs, NCAs, CALs, MEDCAC, technology assessments) within the last N days with CMS's change description, and local (LCDs and articles) from CMS's 'What's New' local report. Use for 'what changed this month' questions."
    },
    {
      "name": "coverage_compare_states",
      "title": "Compare LCDs for a topic across states",
      "description": "Compares which active Local Coverage Determinations on a topic (title keyword) apply in each of several states, grouped by state and MAC. Also lists any national NCD with a matching title, which applies everywhere. Use for 'does coverage of X differ by state' questions."
    },
    {
      "name": "coverage_describe_dataset",
      "title": "Describe the CMS Coverage API source",
      "description": "Explains the CMS Coverage API / Medicare Coverage Database: document types (NCD, NCA, CAL, LCD, article), what this server returns, the license gate on LCD/article text and codes, state jurisdictions, update cadence and caveats."
    }
  ]
}