MCP server for DME billing and medical coding: HCPCS, ICD-10 and CPT lookup, DMEPOS fee schedules, Medicare prior-auth and F2F checks, denial codes, claim checks. 32 tools, 6 free. PHI-free.
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MCP_API_KEYAPI keyoptionalMyMedi-AI API key for the paid tools; the six free tools work without one
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decode-denialExplain a CARC denial code and build an action plan to fix, resubmit, or appeal the claim.Explain a CARC denial code and build an action plan to fix, resubmit, or appeal the claim.
No input schema was published for this tool.
order-readinessAssemble the blank pre-delivery paperwork checklist for a HCPCS code: SWO elements, F2F/WOPD, and prior authorization.Assemble the blank pre-delivery paperwork checklist for a HCPCS code: SWO elements, F2F/WOPD, and prior authorization.
No input schema was published for this tool.
scrub-claimCheck a draft DME claim's codes and date of service with claims_validate, check prior-authorization and F2F/WOPD list requirements with the free tools, and turn the findings into a prioritized pre-submission fix list.Check a draft DME claim's codes and date of service with claims_validate, check prior-authorization and F2F/WOPD list requirements with the free tools, and turn the findings into a prioritized pre-submission fix list.
No input schema was published for this tool.
draft-appealDecode a denial code and structure a redetermination/appeal letter outline with the supporting documentation to attach.Decode a denial code and structure a redetermination/appeal letter outline with the supporting documentation to attach.
No input schema was published for this tool.
estimate-reimbursementPull the DMEPOS fee schedule for a code and state and explain the rental-vs-purchase and rural-vs-non-rural options.Pull the DMEPOS fee schedule for a code and state and explain the rental-vs-purchase and rural-vs-non-rural options.
No input schema was published for this tool.
pa_required_checkCheck whether a HCPCS code is on the current CMS Required Prior Authorization List (42 CFR 414.234) on a date of service (default today). Returns paRequired flag, category, nationwide-since date, and list version. Some items are phased in by state: for those, paRequired is null until a state is giv…Check whether a HCPCS code is on the current CMS Required Prior Authorization List (42 CFR 414.234) on a date of service (default today). Returns paRequired flag, category, nationwide-since date, and list version. Some items are phased in by state: for those, paRequired is null until a state is giv…
No input schema was published for this tool.
denial_code_infoExplain a DME claim denial code (CARC). Returns title, meaning, common DME causes, fixes, appealability, and related codes. Free, no API key required.Explain a DME claim denial code (CARC). Returns title, meaning, common DME causes, fixes, appealability, and related codes. Free, no API key required.
No input schema was published for this tool.
code_lookup_basicLook up basic metadata for a medical code: code, codeType, description, category, isActive. Basic metadata only — the paid code_lookup adds full metadata. Free, no API key required.Look up basic metadata for a medical code: code, codeType, description, category, isActive. Basic metadata only — the paid code_lookup adds full metadata. Free, no API key required.
No input schema was published for this tool.
reimbursement_basicLook up Medicare payment for a code. Returns the national facility and non-facility payment under the current Medicare PFS (CMS RVU × conversion factor) for professional services, plus ranges from the current CMS DMEPOS fee schedule quarter (rental/purchase, min–max across state fees) for DME items…Look up Medicare payment for a code. Returns the national facility and non-facility payment under the current Medicare PFS (CMS RVU × conversion factor) for professional services, plus ranges from the current CMS DMEPOS fee schedule quarter (rental/purchase, min–max across state fees) for DME items…
No input schema was published for this tool.
order_readiness_checklistNo description publishedThis tool published no description. Forge does not invent one.
modifier_advisorEditorial guidance on DMEPOS billing modifiers: the KX/GA/GY/GZ medical-necessity and liability family, RR/NU/UE rental-vs-purchase, capped-rental month markers (KH/KI/KJ), and RT/LT laterality. Pass a HCPCS code to scope guidance to that item's DMEPOS category, or a category directly; add a scenar…Editorial guidance on DMEPOS billing modifiers: the KX/GA/GY/GZ medical-necessity and liability family, RR/NU/UE rental-vs-purchase, capped-rental month markers (KH/KI/KJ), and RT/LT laterality. Pass a HCPCS code to scope guidance to that item's DMEPOS category, or a category directly; add a scenar…
No input schema was published for this tool.
code_lookupLook up a medical code (ICD-10, CPT, HCPCS). Returns description, category, active status, and related codes. For DMEPOS (HCPCS) codes it also returns a labeled fee schedule: per-modifier (RR/NU/UE) national min–max ranges, or — when a state is given — that state's exact non-rural and rural rates.…Look up a medical code (ICD-10, CPT, HCPCS). Returns description, category, active status, and related codes. For DMEPOS (HCPCS) codes it also returns a labeled fee schedule: per-modifier (RR/NU/UE) national min–max ranges, or — when a state is given — that state's exact non-rural and rural rates.…
No input schema was published for this tool.
code_lookup_batchLook up a list of medical codes (ICD-10, CPT, HCPCS) in one call. Per-item results mirror code_lookup (description, category, active status, related codes, DMEPOS fee schedule with optional state filter). Priced per code — $0.001 × number of codes, max 25 per call; the full charge is refunded autom…Look up a list of medical codes (ICD-10, CPT, HCPCS) in one call. Per-item results mirror code_lookup (description, category, active status, related codes, DMEPOS fee schedule with optional state filter). Priced per code — $0.001 × number of codes, max 25 per call; the full charge is refunded autom…
No input schema was published for this tool.
code_suggestNo description publishedThis tool published no description. Forge does not invent one.
code_validateCheck that an ICD-10-CM, CPT or HCPCS Level II code exists and is valid on a date of service: termination and effective dates are applied, so a code deleted after that date still validates. dateOfService is YYYY-MM-DD (default today); asOf in the result is the date the code was judged for. Returns…Check that an ICD-10-CM, CPT or HCPCS Level II code exists and is valid on a date of service: termination and effective dates are applied, so a code deleted after that date still validates. dateOfService is YYYY-MM-DD (default today); asOf in the result is the date the code was judged for. Returns…
No input schema was published for this tool.
code_validate_batchValidate up to 25 medical codes in one call, each judged as code_validate judges one: exists, and is valid on the date of service (dateOfService, YYYY-MM-DD, applied to every code; default today). Per-item results mirror code_validate (valid, active, asOf, warnings, errors, codeDetails). Priced per…Validate up to 25 medical codes in one call, each judged as code_validate judges one: exists, and is valid on the date of service (dateOfService, YYYY-MM-DD, applied to every code; default today). Per-item results mirror code_validate (valid, active, asOf, warnings, errors, codeDetails). Priced per…
No input schema was published for this tool.
pa_predictNo description publishedThis tool published no description. Forge does not invent one.
pa_statusCheck the status of a prior authorization request tracked in your MyMedi-AI web workspace (by its MyMedi-AI PA id). Returns current status, dates, and expiration info. It does not query payers, and returns not-found (refunded) if the PA was never entered in the web app — for a code's PA requirement…Check the status of a prior authorization request tracked in your MyMedi-AI web workspace (by its MyMedi-AI PA id). Returns current status, dates, and expiration info. It does not query payers, and returns not-found (refunded) if the PA was never entered in the web app — for a code's PA requirement…
No input schema was published for this tool.
pa_exposure_reportNo description publishedThis tool published no description. Forge does not invent one.
ner_extractNo description publishedThis tool published no description. Forge does not invent one.
claims_validateNo description publishedThis tool published no description. Forge does not invent one.
compliance_auditNo description publishedThis tool published no description. Forge does not invent one.
drug_lookupLook up drug information including label data, adverse events, and related diagnosis codes. Source: openFDA (FDA drug labels and adverse-event reports); related diagnosis codes come from the MyMedi-AI code database.Look up drug information including label data, adverse events, and related diagnosis codes. Source: openFDA (FDA drug labels and adverse-event reports); related diagnosis codes come from the MyMedi-AI code database.
No input schema was published for this tool.
drug_interactionsNo description publishedThis tool published no description. Forge does not invent one.
code_reimbursementLook up Medicare reimbursement rates for a medical code. Returns RVU values and estimated payment amounts using the PFS conversion factor. Source: the current Medicare PFS (CMS RVU files).Look up Medicare reimbursement rates for a medical code. Returns RVU values and estimated payment amounts using the PFS conversion factor. Source: the current Medicare PFS (CMS RVU files).
No input schema was published for this tool.
fee_schedule_lookupLook up the CMS DMEPOS fee schedule for a DME/orthotic/prosthetic HCPCS code: rental (RR) vs purchase (NU new / UE used), non-rural vs rural, per state. Give a state for exact rates, or omit for national min–max ranges; filter by modifier to narrow to rental or purchase. Source: the current CMS DME…Look up the CMS DMEPOS fee schedule for a DME/orthotic/prosthetic HCPCS code: rental (RR) vs purchase (NU new / UE used), non-rural vs rural, per state. Give a state for exact rates, or omit for national min–max ranges; filter by modifier to narrow to rental or purchase. Source: the current CMS DME…
No input schema was published for this tool.
trials_searchSearch active clinical trials by condition, ICD-10 code, or intervention. Returns trial details including NCT ID, phase, enrollment, and eligibility. Source: ClinicalTrials.gov.Search active clinical trials by condition, ICD-10 code, or intervention. Returns trial details including NCT ID, phase, enrollment, and eligibility. Source: ClinicalTrials.gov.
No input schema was published for this tool.
code_crossrefNo description publishedThis tool published no description. Forge does not invent one.
drug_rxnormNormalize a drug name with NIH RxNorm: returns the matching RxNorm concepts (RxCUI, name, synonym, term type) and the primary RxCUI. It does not check interactions — use drug_interactions for drug-drug interaction signals. Source: RxNorm, from the U.S. National Library of Medicine (RxNav API).Normalize a drug name with NIH RxNorm: returns the matching RxNorm concepts (RxCUI, name, synonym, term type) and the primary RxCUI. It does not check interactions — use drug_interactions for drug-drug interaction signals. Source: RxNorm, from the U.S. National Library of Medicine (RxNav API).
No input schema was published for this tool.
provider_paymentsLook up pharmaceutical and device company payments to a physician (Sunshine Act data). Returns total payments, breakdown by type, and top paying companies. Source: CMS Open Payments.Look up pharmaceutical and device company payments to a physician (Sunshine Act data). Returns total payments, breakdown by type, and top paying companies. Source: CMS Open Payments.
No input schema was published for this tool.
disease_surveillanceLook up disease surveillance data including case counts and trends by condition and geography. Source: CDC National Notifiable Diseases Surveillance System (NNDSS) weekly data on data.cdc.gov.Look up disease surveillance data including case counts and trends by condition and geography. Source: CDC National Notifiable Diseases Surveillance System (NNDSS) weekly data on data.cdc.gov.
No input schema was published for this tool.
provider_searchSearch the NPI provider directory. Find healthcare providers by name, specialty, or location.Search the NPI provider directory. Find healthcare providers by name, specialty, or location.
No input schema was published for this tool.
provider_enrichLook up a provider by NPI in the CMS NPPES registry (name, credential, primary and other taxonomies, practice address, enumeration date) and add an LLM-generated estimate, labelled as such, of specialty demand, network gaps and referral categories for that type of provider. The model is given the p…Look up a provider by NPI in the CMS NPPES registry (name, credential, primary and other taxonomies, practice address, enumeration date) and add an LLM-generated estimate, labelled as such, of specialty demand, network gaps and referral categories for that type of provider. The model is given the p…
No input schema was published for this tool.
drug_enrichNo description publishedThis tool published no description. Forge does not invent one.
market_analysisSpecialty snapshot for a US state: how many providers one CMS NPPES registry query matches for the specialty (the query returns at most 200 records, so the figure is a floor, not a provider count), plus an LLM-generated estimate, labelled as such, of demand outlook, likely underserved areas and opp…Specialty snapshot for a US state: how many providers one CMS NPPES registry query matches for the specialty (the query returns at most 200 records, so the figure is a floor, not a provider count), plus an LLM-generated estimate, labelled as such, of demand outlook, likely underserved areas and opp…
No input schema was published for this tool.
account_statusCheck your MyMedi-AI account: current credit balance, USD equivalent, transaction count, recent transactions, and last activity. Free — never bills credits. Uses your connector sign-in (or X-API-Key when self-hosted).Check your MyMedi-AI account: current credit balance, USD equivalent, transaction count, recent transactions, and last activity. Free — never bills credits. Uses your connector sign-in (or X-API-Key when self-hosted).
No input schema was published for this tool.
buy_creditsNo description publishedThis tool published no description. Forge does not invent one.
26 of 37 tools published a description.
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MCP server for DME billing and medical coding: HCPCS, ICD-10 and CPT lookup, DMEPOS fee schedules, Medicare prior-auth and F2F checks, denial codes, claim checks. 32 tools, 6 free. PHI-free.
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