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.
Reference-quality API operations across every facet — a rich contract, published governance, transparent operations, and machine-readable commercial terms.
API Evangelist profiles Centers for Medicare and Medicaid Services the way a machine reads it — 176 machine-readable artifacts across 4 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 81.3/100 (exemplar), with a separate agent-readiness read of 42/100 (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. Every facet and dimension name is a link: it opens that measurement's page on APIs.io, where the rating runs across the whole catalog — the exact checks that feed it, how every profiled provider distributes on it, and who is at the top of it.
Kin Score
How this is scored →scored 2026-09-08 · rubric v0.20.0
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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 41
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 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.
CMS Socrata Open Data API (data.cms.gov)
data.cms.gov hosts hundreds of CMS datasets including Medicare Fee-for-Service utilization and payment data, Provider of Services files, Medicare Part B/D Prescriber summaries, ...
CMS Provider Data Catalog API (Care Compare)
The Provider Data Catalog API (formerly Hospital Compare) exposes the Medicare.gov Care Compare datasets including Hospital, Nursing Home, Home Health, Hospice, Physician, Long-...
NPPES NPI Registry API
The NPPES NPI Registry API provides free public access to look up active National Provider Identifier records for individual and organizational healthcare providers, supporting ...
Healthcare.gov Marketplace API
The Healthcare.gov Marketplace API and accompanying Open Data Plan Finder exposes Qualified Health Plan (QHP) details, plan attributes, provider networks, and formularies for th...
CMS Quality Payment Program (QPP) Measures API
The Quality Payment Program Measures Data repository and REST API publish machine-readable specifications of MIPS quality, promoting interoperability, improvement activities, an...
Medicare Coverage Database (MCD) API
The Medicare Coverage Database publishes National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), articles, and coding guidance used to determine Medicare ...
Centers for Medicare and Medicaid Services Capability API
FHIR server capability statements and metadata.
Centers for Medicare and Medicaid Services Coverage API
Beneficiary coverage records.
Centers for Medicare and Medicaid Services ExplanationOfBenefit API
Medicare claims expressed as ExplanationOfBenefit resources.
Centers for Medicare and Medicaid Services Patient API
Beneficiary (Patient) resources.
Centers for Medicare and Medicaid Services 1. Export API
API through which an authenticated and authorized PDP sponsor may request a bulk-data export from a server.
Centers for Medicare and Medicaid Services 2. Status API
API to determine the status of the job, the files to download once the job is complete and an endpoint to cancel a job
Centers for Medicare and Medicaid Services 3. Download API
After creating a job, the API to download the generated bulk download files
Centers for Medicare and Medicaid Services 4. Capabilities API
Provide the standard required FHIR capability statement
Centers for Medicare and Medicaid Services Admin API
The admin-api API from Centers for Medicare and Medicaid Services — 5 operation(s) for admin-api.
Centers for Medicare and Medicaid Services Attribution API
The attribution API from Centers for Medicare and Medicaid Services — 2 operation(s) for attribution.
Centers for Medicare and Medicaid Services Auth API
The auth API from Centers for Medicare and Medicaid Services — 3 operation(s) for auth.
Centers for Medicare and Medicaid Services Capabilities API
Provide the standard required FHIR capability statement
Centers for Medicare and Medicaid Services Data API
The data API from Centers for Medicare and Medicaid Services — 1 operation(s) for data.
Centers for Medicare and Medicaid Services Download API
After creating a job, the API to download the generated bulk download files
Centers for Medicare and Medicaid Services Export API
API through which an authenticated and authorized PDP sponsor may request a bulk-data export from a server.
Centers for Medicare and Medicaid Services Group API
The group API from Centers for Medicare and Medicaid Services — 2 operation(s) for group.
Centers for Medicare and Medicaid Services Health API
The health-api API from Centers for Medicare and Medicaid Services — 1 operation(s) for health-api.
Centers for Medicare and Medicaid Services Job API
The job API from Centers for Medicare and Medicaid Services — 4 operation(s) for job.
Centers for Medicare and Medicaid Services Maintenance Mode API
The maintenance-mode-api API from Centers for Medicare and Medicaid Services — 1 operation(s) for maintenance-mode-api.
Centers for Medicare and Medicaid Services Metadata API
The metadata API from Centers for Medicare and Medicaid Services — 3 operation(s) for metadata.
Centers for Medicare and Medicaid Services Status API
API to determine the status of the job, the files to download once the job is complete and an endpoint to cancel a job
Scroll within the panel for all 41 ·
Open Collections 17
Open, tool-agnostic collections carry the same runnable value as Postman without locking you to one client — the portable, forkable form of the same exercise.
Open, tool-agnostic API collections (OpenAPI-derived and Bruno).
API Collection
OPEN COLLECTIONMarketplace API Reference API
OPEN COLLECTIONMarketplace API Reference Bulk Data API
OPEN COLLECTIONCMS Blue Button 2.0 Capability API
OPEN COLLECTIONCMS Blue Button 2.0 API
OPEN COLLECTIONMarketplace API Reference Code Search API
OPEN COLLECTIONMarketplace API Reference Cost Search API
OPEN COLLECTIONCMS Blue Button 2.0 Capability Coverage API
OPEN COLLECTIONMarketplace API Reference Enrollments API
OPEN COLLECTIONCMS Blue Button 2.0 Capability ExplanationOfBenefit API
OPEN COLLECTIONMarketplace API Reference Geography API
OPEN COLLECTIONMarketplace API Reference Households & Eligibility API
OPEN COLLECTIONMarketplace API Reference Insurance Issuers API
OPEN COLLECTIONMarketplace API Reference Insurance Plans API
OPEN COLLECTIONCMS Blue Button 2.0 Capability Patient API
OPEN COLLECTIONMarketplace API Reference Plans API
OPEN COLLECTIONMarketplace API Reference Provider & Drug Coverage API
OPEN COLLECTIONScroll within the panel for all 17 ·
Pricing Plans 2
Pricing is part of the interface. Machine-readable plans tell you what a tier costs and includes before you commit — one of the things the Kin Score reads for access clarity — renamed from commercial clarity in rubric 0.12, because a free statutory interface has access terms and no commercial ones.
Published pricing tiers and plan structures.
Cms Plans Pricing
PLANSPlans
PLANSRate Limits 2
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.
Cms Rate Limits
RATE LIMITSRate Limits
RATE LIMITSFinOps 2
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.
Cms Finops
FINOPSFinops
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 4
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.
Scopes 1
OAuth scopes are the vocabulary of least-privilege access. Profiling them shows exactly what an integration — or an agent acting on a user's behalf — is allowed to do.
OAuth scopes governing access to this provider's APIs.
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 6
Portal, sign-up, and the first successful call
Documentation 8
Reference material describing how the API behaves
Scroll within the panel for all 8 ·
Agent Surfaces 7
MCP servers, agent skills, and machine-readable catalogs
Scroll within the panel for all 7 ·
Design & Contract 10
Pagination, idempotency, versioning, errors, and events
Scroll within the panel for all 10 ·
Build 11
SDKs, sample code, and the tooling you integrate with
Scroll within the panel for all 11 ·
Access & Security 8
Authentication, authorization, and security posture
Scroll within the panel for all 8 ·
Operate 7
Status, limits, changes, and where to get help
Scroll within the panel for all 7 ·
Commercial 5
Pricing, plans, and the legal terms of use
Company 1
The organization behind the API
Other 16
Properties that don't map to a standard resource type
Scroll within the panel for all 16 ·
← All providers · Data indexed from github.com/api-evangelist/cms · machine-readable index on apis.io
This is an independent, third-party profile of Centers for Medicare and Medicaid Services, published by API Evangelist. We do not operate, host, resell, or support these APIs, and we are not affiliated with or endorsed by the company unless stated above. Everything here is built from publicly available information — the company's own site, developer portal, documentation, public repositories, and the specifications it publishes for public use. Nothing is obtained by breaching a system, defeating an access control, or using credentials.
The Kin Score and Agent Readiness rating are independently calculated assessments of a company's public API artifacts, scored against a published rubric. They are not certifications, endorsements, security assessments, or audits.
Corrections, re-scores, and removal are free — no partnership or purchase required, and you do not need to justify the request. A removed company is recorded as unrated, never scored zero for having asked. Acknowledgement within one business day; removal within two.
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