Centers for Medicare and Medicaid Services
The Centers for Medicare and Medicaid Services (CMS) provides a suite of public REST APIs enabling developers to access Medicare provider data, quality measures, drug spending, health plan finder, beneficiary claims, and public health insurance datasets. CMS APIs support interoperability standards including HL7 FHIR and OAuth 2.0 to power healthcare applications across the US health system.
Limited machine-readable signal and partial portal coverage — documentation a human can read, but little a machine or agent can consume without scraping.
API Evangelist profiles Centers for Medicare and Medicaid Services the way a machine reads it — 128 machine-readable artifacts across 16 APIs, pulled from the provider's own public surface and indexed so a developer, an analyst, or an AI agent can evaluate it against every other provider on the network.
Every provider in the network is reduced to the same set of machine-readable artifacts — OpenAPI contracts, event specifications, GraphQL schemas, runnable collections, pricing and rate-limit signals, security posture, OAuth scopes, and the agent surfaces (MCP servers and skills) that let software drive the API on its own. We profile them because the interface is the part of a company you can actually inspect: it is a truer signal of what a provider does than any marketing page. From those artifacts we compute the Kin Score — Centers for Medicare and Medicaid Services scores 44.6/100 (thin), with a separate agent-readiness read of 48/100 (agent ready). The full breakdown is below, followed by every artifact we hold — each card links through to its machine-readable definition on apis.io.
Kin Score
This is the API Evangelist rating — a single, repeatable read computed from the artifacts on this page. Green fill is points earned; the red track is points possible, so every bar shows earned-versus-possible at a glance.
Kin Score
How this is scored →scored 2026-07-27 · rubric v0.5
How we profile Centers for Medicare and Medicaid Services
Each block below is one kind of artifact we hold for Centers for Medicare and Medicaid Services. For each we say what it is and why it earns a place in the profile, then list every one we've indexed — capped at two rows, scroll within the panel for the rest.
APIs 16
Each API is captured as its own OpenAPI definition — every operation, parameter, and response. This is the single most useful machine-readable description of what an API does, and it's what lets us score, lint, mock, and generate against it without asking the provider for anything.
Individual APIs this provider publishes, each with its own machine-readable definition.
CMS Beneficiary Claims Data API (BCDA)
Enables Medicare Accountable Care Organizations (ACOs) and alternative payment model participants to retrieve Medicare Part A, B, and D claims data for their attributed enrollee...
CMS AB2D API (Claims Data to Part D Sponsors)
Enables stand-alone Medicare Part D Prescription Drug Plan sponsors to retrieve bulk Medicare Part A and B claims data for their active beneficiaries using the FHIR standard in ...
CMS Data at the Point of Care (DPC) API
Provides Original Medicare claims data to fee-for-service Medicare providers in a structured, standardized FHIR format at the point of care. Helps providers gain complete views ...
CMS Finder API
The API behind Finder.Healthcare.gov that helps users find private health plans available outside the Health Insurance Marketplace. Supports individual plan lookups, small group...
CMS Quality Payment Program (QPP) Submissions API
Enables QPP participants to submit quality performance data and receive real-time performance scoring feedback. Supports Merit-based Incentive Payment System (MIPS) and Advanced...
Centers for Medicare and Medicaid Services API Reference API
Information about the state of Marketplace API.
Centers for Medicare and Medicaid Services Bulk Data API
Information about the bulk data json files maintained by Marketplace API.
Centers for Medicare and Medicaid Services Code Search API
Search CPT/HCPCS codes by procedure codes or terms describing medical procedures. Get code details for a given procedure code.
Centers for Medicare and Medicaid Services Cost Search API
For a given procedure code or entire set of codes, get national averages for the amount Medicare pays hospitals or surgical centers, and the national average copay amounts.
Centers for Medicare and Medicaid Services Enrollments API
Enrollment grouping validation and information.
Centers for Medicare and Medicaid Services Geography API
Geographic data, including information on states, counties, and zipcodes.
Centers for Medicare and Medicaid Services Households & Eligibility API
Household specific calculations, including eligibility information, out of pocket costs, poverty levels, and cost benchmarks.
Centers for Medicare and Medicaid Services Insurance Issuers API
Data related to health insurance issuers on the marketplace.
Centers for Medicare and Medicaid Services Insurance Plans API
Data on both health and dental insurance plans.
Centers for Medicare and Medicaid Services Plans API
The Plans API from Centers for Medicare and Medicaid Services — 1 operation(s) for plans.
Centers for Medicare and Medicaid Services Provider & Drug Coverage API
Lookup information on providers, drugs, and what is covered under what plans.
Scroll within the panel for all 16 ·
Pricing Plans 1
Pricing is part of the interface. Machine-readable plans tell you what a tier costs and includes before you commit — one of the six things the Kin Score reads for commercial clarity.
Published pricing tiers and plan structures.
Plans
PLANSRate Limits 1
Rate limits are the difference between a demo that works and a production integration that doesn't fall over. Publishing them is an operational-transparency signal — and a hard requirement for any agent that plans its own throughput.
Documented rate limits and quota policies.
Rate Limits
RATE LIMITSFinOps 1
Cost, billing, and metering signals let a buyer model the financial operations of an API before it's live. We profile them for the same reason we profile pricing: the money is part of the contract.
Cost, billing, and metering signals for API financial operations.
Finops
FINOPSSemantic Vocabularies 2
JSON-LD contexts give the data shared meaning across APIs. We profile them because semantics are what let a machine reconcile 'customer' here with 'customer' somewhere else.
JSON-LD contexts and semantic vocabularies used across these APIs.
Cms Apis Context
JSON-LDCms Context
JSON-LDSpectral Rules 1
Governance rulesets we run against this provider's specs — the automated checks behind parts of the score. Profiling them makes the quality bar explicit and re-runnable, not a matter of opinion.
JSON Schema 93
Standalone JSON Schema definitions describe the data models behind the API. We profile them so the shapes are validatable on their own — useful long after a single request is forgotten.
Standalone JSON Schema definitions for this provider's data models.
Address
JSON SCHEMAApplicationError400
JSON SCHEMAApplicationError404
JSON SCHEMAAPT
JSON SCHEMAAPTC
JSON SCHEMAAPTCAllocationResult
JSON SCHEMAAPTCEnrollee
JSON SCHEMAAPTCEnrollmentGroup
JSON SCHEMAAPTTier
JSON SCHEMABenefit
JSON SCHEMACertificationStatus
JSON SCHEMACostSharing
JSON SCHEMACostSharingReductionEnum
JSON SCHEMACounty
JSON SCHEMACountyZips
JSON SCHEMACoverage
JSON SCHEMACrosswalk
JSON SCHEMACrosswalkCode
JSON SCHEMACrosswalkData
JSON SCHEMACSREligibilityEnum
JSON SCHEMACSRRequestEnum
JSON SCHEMACurrentEnrollment
JSON SCHEMADataVersion
JSON SCHEMADecileEnum
JSON SCHEMADecileMapping
JSON SCHEMADecileUtilizationAgeMap
JSON SCHEMADecileUtilizationMapping
JSON SCHEMADeductible
JSON SCHEMADesignTypeEnum
JSON SCHEMADiseaseMgmtProgramsEnum
JSON SCHEMADrug
JSON SCHEMADrugCoverage
JSON SCHEMAEligibility
JSON SCHEMAEnrollee
JSON SCHEMAEnrollment
JSON SCHEMAEnrollmentGroup
JSON SCHEMAExtendedEnrollee
JSON SCHEMAExtendedEnrollment
JSON SCHEMAFamilyCostEnum
JSON SCHEMAFlattenedEnrollmentGroup
JSON SCHEMAGenderEnum
JSON SCHEMAGuideline
JSON SCHEMAHousehold
JSON SCHEMAHRA
JSON SCHEMAICHRAResponse
JSON SCHEMAInsuranceMarketEnum
JSON SCHEMAIssuer
JSON SCHEMALowestCostPlanHousehold
JSON SCHEMALowestCostPlanPerson
JSON SCHEMALowestCostPlanResponse
JSON SCHEMALowIncomeChild
JSON SCHEMAMarketEnum
JSON SCHEMAMarketplaceModelEnum
JSON SCHEMAMarketYear
JSON SCHEMAMarketYears
JSON SCHEMAMetalDesignType
JSON SCHEMAMetalLevelEnum
JSON SCHEMAMOOP
JSON SCHEMANearbyProvider
JSON SCHEMANetworkTierEnum
JSON SCHEMANPI
JSON SCHEMAPerson
JSON SCHEMAPlace
JSON SCHEMAPlan
JSON SCHEMAPlanID
JSON SCHEMAPlanIDList
JSON SCHEMAPlanSearchFilter
JSON SCHEMAPlanSearchRequest
JSON SCHEMAPlanTypeEnum
JSON SCHEMAPovertyGuideline
JSON SCHEMAProductDivisionEnum
JSON SCHEMAProvider
JSON SCHEMAProviderCoverage
JSON SCHEMAProviderGenderEnum
JSON SCHEMAProviderTypeEnum
JSON SCHEMAQualityRating
JSON SCHEMARange
JSON SCHEMARateArea
JSON SCHEMARateAreaCounty
JSON SCHEMARelationship
JSON SCHEMARelationshipEdge
JSON SCHEMARxCUI
JSON SCHEMASBCScenario
JSON SCHEMAState
JSON SCHEMAStateCounty
JSON SCHEMAStateMedicaid
JSON SCHEMAStateMedicaidList
JSON SCHEMAStateRateArea
JSON SCHEMASuppressionStatus
JSON SCHEMAUtilizationEnum
JSON SCHEMAZIPCounty
JSON SCHEMACode
JSON SCHEMACost
JSON SCHEMAScroll within the panel for all 93 ·
Examples 10
Real request and response payloads are what turn a spec from abstract into obvious — and they're one of the twelve things an agent needs to call an API correctly on the first try.
Example request and response payloads for these APIs.
Marketplace Address Example
EXAMPLEMarketplace Drug Example
EXAMPLEMarketplace Issuer Example
EXAMPLEMarketplace Person Example
EXAMPLEMarketplace Plan Example
EXAMPLEMarketplace Provider Example
EXAMPLEPpl Code Example
EXAMPLEPpl Cost Example
EXAMPLEScroll within the panel for all 10 ·
Security Posture 2
Authentication, domain security, vulnerability disclosure, and trust-center signals — the evidence that a provider takes security seriously enough to document it. We profile it because you can't govern what you can't see.
Authentication, domain security, vulnerability disclosure, and trust-center signals.
Agentic Access 1
An x-agentic-access contract marks which operations are safe for an agent to run on its own and which need a human in the loop. It is the difference between an API an agent can use and one it can use safely.
Recommended x-agentic-access execution contracts for AI agents.
Resources
Every other property we hold for Centers for Medicare and Medicaid Services — documentation, portals, status pages, policies, and corporate surface — grouped by the job it does, following the integrator's arc from getting started to running in production.
Get Started 2
Portal, sign-up, and the first successful call
Agent Surfaces 1
MCP servers, agent skills, and machine-readable catalogs
Build 1
SDKs, sample code, and the tooling you integrate with
Access & Security 2
Authentication, authorization, and security posture
Other 3
Properties that don't map to a standard resource type
← All providers · Data indexed from github.com/api-evangelist/cms · machine-readable index on apis.io