Procedure Coverage

io.github.builtforaiPublished by GitHub account builtforaiv1.0.0Updated Oct 27, 2026

Medicare coverage and fee-schedule amounts for CPT/HCPCS codes against a diagnosis

VerifiedStreamable HTTPWeb executableFinanceData & Analytics

Overview

AI-generated overview

Remote MCP server that reports CMS Medicare Local Coverage Article coverage and Physician Fee Schedule amounts for CPT/HCPCS codes against a diagnosis.

What you can do
  • Look up Medicare coverage for a diagnosis plus one or more CPT/HCPCS codes
  • Report what CMS Local Coverage Articles record for each code
  • List the ICD-10 diagnoses those articles mark as covered or non-covered
  • Return the CMS Physician Fee Schedule professional amount where a national rate exists
When to use it
Useful when checking whether a procedure is covered by Medicare for a given diagnosis, or when you need the national professional fee-schedule amount for a code, for example in billing, coding or reimbursement research.
Requirements
A remote MCP endpoint at medicalclaim.ai over streamable HTTP; no packages, environment variables or headers are declared, and no authentication is declared.
Before you install
Results reflect CMS Local Coverage Articles and the national fee schedule only; local coverage decisions and setting-specific rules may differ, so figures should be verified before billing or clinical use.

Installation

In SourceWeft

  1. Open Procedure Coverage in the dashboard and add it to a workspace.
  2. Enable the server for the chats that should use its tools.

Web executable via Streamable HTTP. Remote servers run from the web runtime once configured in a workspace.

Use with an agent

Paste this prompt into Claude Code, Codex, Cursor or another agent — or into SourceWeft chat. The agent reads this server's install guide, shows you its publisher, endpoint and sign-in, and adds it to your client once you agree. Keys never go into a command.

Read https://sourceweft.com/mcp/io.github.builtforai%2Fprocedure-coverage/install.md and connect the MCP server it describes to my client. Before changing any config, show me its publisher, endpoint and sign-in method and wait for my OK. Never put an API key in a command or in a file I would commit; ask me where it should come from.

Read the install guide the agent follows

Other MCP clients

Add this to your client's mcpServers config.

{
  "mcpServers": {
    "procedure-coverage": {
      "type": "http",
      "url": "https://medicalclaim.ai/mcp"
    }
  }
}

README

This repository has no README.

Tools

1

medicare_procedure_coverage

For a diagnosis and one or more CPT/HCPCS codes, report what CMS Local Coverage Articles record for each code, which ICD-10 diagnoses those articles list as covered or non-covered, and the CMS Physician Fee Schedule PROFESSIONAL amount where a national rate exists. Setting matters and is stated: codes performed only in a facility return not_applicable_in_this_setting rather than an invented office price, and codes CMS does not pay under the PFS (status I, X, N, E, B, P) return not_payable_under_pfs rather than a figure computed from published RVUs. Coverage is contractor-specific. Does NOT compare clinical effectiveness or recommend treatment, and a missing national rate is never treated as non-coverage. The amount is the clinician fee only — not the facility fee, device or imaging.

Parameterscodesdiagnosis

Version history

1
  1. v1.0.0LatestSep 18, 2026

Score

75% of the applicable checks met

How complete this listing is, computed from the registry entry, the endpoint and public sources. Not a rating of the server and not a statement that it is safe or working today: reachability is a dated check, and no installs or reviews go into the score.

  • Reached in the last 30 daysRequired25 pts
  • Auth declaredRequired10 pts
  • Tools listedRequired15 pts
  • DescriptionRequired15 pts
  • Logo10 pts
  • Documentation15 pts

    Declare a GitHub repository with a README, or serve resource_documentation in the OAuth protected-resource metadata.

  • License10 pts

    Declare a license in the repository or the registry entry.