Medicare PFS API

Computed, release-versioned Medicare Physician Fee Schedule rates — no CMS file parsing, no RVU/GPCI math to get right yourself. Every response echoes the release that answered it and cites the exact source row.

The API we're building Not live yet

The same number, programmatically — the bulk endpoint returns the payable amount, status, the release that answered it, and full citations (CMS file, row, and the math) for every code in one call. This is the shape it will ship in; keys aren't open yet.

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curl -X POST -H "Authorization: Bearer $API_KEY" \
  -H "Content-Type: application/json" \
  -d '{"codes":["99203"],"setting":"non_facility"}' \
  "https://localishealth.com/v1/rates/bulk"

Returns the national amount (GPCI 1.000). Add "locality" to the request body for a locality-adjusted rate — the calculator has a searchable locality picker. The same rate is on this page today, free — tell us what you'd automate with it.

Endpoints

Endpoint	What it returns
GET /v1/rates/{hcpcs}	One code's payable amount, status, release, and citations — optionally locality-adjusted.
POST /v1/rates/bulk	Up to 500 codes in one call, same shape as a single lookup.
POST /v1/claims/check	One claim's lines checked together: MPPR ranking, NCCI PTP bundling, and MUE unit limits.
GET /v1/releases	Every ingested PFS release, current and historical.
GET /v1/localities	Every Medicare payment locality, for resolving a locality parameter.

Authentication & quota

Every request will need a bearer token — Authorization: Bearer <token>. The planned entry tier is 10,000 lookups per day (a single-code lookup costs 1 unit; a bulk request costs one unit per code), with a 600-unit burst limit per minute. Keys aren't open yet — the waitlist is how you get one first.

Join the waitlist

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