CMS Coverage MCP Server

The CMS Coverage MCP server gives an AI agent direct access to the Centers for Medicare & Medicaid Services (CMS) Medicare Coverage Database, covering Medicare Part B medical services and policies. It exposes National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), proposed LCDs, billing articles, National Coverage Analyses (NCAs), Coverage with Appropriateness Determinations (CALs), MEDCAC meetings, and technology assessments through a single unified search and retrieval interface.

The server is hosted by deepsense.ai at https://mcp.deepsense.ai/cms_coverage/mcp and is one of the healthcare and life sciences connectors built for the Anthropic Claude Connectors Directory. It is publicly accessible with no authentication or paid subscription required. The connector is also published in the anthropics/healthcare GitHub marketplace alongside companion servers for the NPI Registry and PubMed.

The CMS Coverage connector is designed for healthcare workflows such as prior authorization review, coverage policy lookup, billing/coding research, and clinical decision support. It supports pagination via next_page_token for large result sets and can batch fetch up to 20 NCDs in a single call. Coverage is limited to Medicare Part B (medical services); it does not cover Part D prescription drug plans.

Tools

Prerequisites

• Claude Desktop, Claude Code, or any MCP-compatible client supporting remote HTTP transport
• No API key or authentication required

Option 1: Add via Claude Connectors (recommended)

1. Open Claude Desktop → Settings → Connectors
2. Search for "CMS Coverage" and click Enable
3. Workspace admins can enable it for the entire organization

Option 2: Add via Claude Code marketplace

claude mcp add-from-marketplace anthropics/healthcare/cms-coverage

Option 3: Manual config for clients that support remote MCP servers

{
  "mcpServers": {
    "cms-coverage": {
      "url": "https://mcp.deepsense.ai/cms_coverage/mcp"
    }
  }
}

Verify

Try a prompt such as: "Does Medicare cover PET scans?" The agent should call the national coverage search tool and return matching NCDs.

• Look up whether a specific service, procedure, or device is covered by Medicare Part B nationally (NCD search) or in a specific jurisdiction (LCD search)
• Power prior authorization review workflows by pulling the relevant coverage policy text, criteria, and coding requirements for a given CPT/HCPCS code
• Identify which Medicare Administrative Contractor governs a patient's state and pull the matching LCDs and billing articles
• Check whether an oral drug is on the Self-Administered Drug exclusion list before submitting a Part B claim
• Monitor the "What's New" feed to track recent NCD, LCD, or article changes that may impact billing or compliance

• "Does Medicare cover continuous glucose monitors? Pull the relevant NCD and summarize the coverage criteria."
• "Find all LCDs for Novitas Solutions in New Jersey related to skin substitute grafts."
• "Is omeprazole on the Medicare Part B SAD exclusion list?"
• "Which MAC covers Texas and what billing articles have they published in the last 60 days?"
• "Compare NCDs 20.4, 20.7, and 20.32 and summarize the key coverage differences."

• Official remote MCP endpoint in the Claude Connectors Directory, no setup or API keys required
• Comprehensive coverage of the CMS Medicare Coverage Database including NCDs, LCDs, articles, NCAs, CALs, MAC lookups, and the SAD exclusion list
• Includes a "What's New" feed and batch retrieval for efficient policy monitoring and comparative analysis
• Pagination support for large result sets via next_page_token

• Scope is limited to Medicare Part B; it does not cover Part D prescription drug plans, Medicaid, or commercial payer policies
• Read-only data access; the server cannot submit claims, prior authorizations, or write back to CMS systems
• Hosted by a third party (deepsense.ai), so availability and latency depend on that provider; not self-hostable from an official public repo

• clarifyhealth/cms-datagov-mcp-server: community MCP server with broader access to data.cms.gov datasets
• openpharma-org/medicare-mcp: community MCP server focused on Medicare provider and claims data
• Direct use of the CMS Coverage API (api.coverage.cms.gov) without an MCP wrapper