Skip to main content
Glama

Compare a charge with Medicare's rate for one service

check_price
Read-onlyIdempotent

Compare a charge with Medicare's rate for one service. For when someone asks whether a charge is high or what Medicare pays, for example "I was charged $450 for a 99213 office visit in Texas, is that too high?" or "what does Medicare pay for an MRI of the knee?". Takes the billing code if they have it, otherwise the service in plain words as q. Returns Medicare's 2026 rate for the state (or the city's own pricing area when city is given) in medicare_2026, the amount providers typically billed in 2024, and how many times the Medicare rate the charge is. For care in a hospital, hospital_facility_2026 gives Medicare's national rate for the hospital's own facility fee and comparison.compared_with says what the charge was set against. Dental work has no Medicare rate and returns 404 with a pointer to a free dental cost source.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
qNoThe service in plain words, used when there is no code, like "knee MRI" or "ER visit".
cityNoCity, for states where Medicare pays big cities differently, like Houston, Chicago, Miami or Los Angeles. Other places use the rest-of-state rate.
codeNoFive-character CPT or HCPCS code from the bill, like 99213, 73721 or G0121.
stateNoUS state name or two-letter code, like Texas or TX. Med Bill Check is for US bills; a UK place gets a short answer pointing to UK sources.
chargedNoThe amount on the bill in US dollars, like 450.
settingNoSetting: office (clinic, office, imaging center) or facility (hospital or surgery center). Leave out to use the usual setting.
billed_byNoWhose bill the charge is on when the service was in a hospital: hospital (the hospital's own facility charge) or doctor (the doctor's or physician group's bill). Leave out if not known: the charge is then compared with both together.

Schema Changelog

Changes observed during successful MCP inspections.

  1. Changed1 schema field changed
    • changedInput schema / properties / setting / description
      Previous value: -"office (clinic, office, imaging center) or facility (hospital or surgery center). Leave out to use the usual setting."New value: +"Setting: office (clinic, office, imaging center) or facility (hospital or surgery center). Leave out to use the usual setting."
  2. First observed

TDQS

A4.4/5.0
Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already declare readOnlyHint, idempotentHint, openWorldHint and destructiveHint=false, so safety is covered. The description adds real behavior beyond that: dental work returns 404 with a pointer to a free source, a UK location yields a short UK-pointer answer, and the pre-2026 billed baseline plus ratio semantics are disclosed. Rate limits or latency are not mentioned, keeping it below 5.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The purpose and situational triggers are front-loaded, and the remaining sentences about return fields and the dental 404 are substantive rather than filler. It runs somewhat long with nested parentheticals, but no sentence is clearly expendable.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness5/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With no output schema, the description carries the full burden of explaining returns and it does so concretely: medicare_2026, the 2024 billed baseline, the multiple-of-Medicare ratio, hospital_facility_2026 and comparison.compared_with, plus the dental 404 path. All seven parameters are covered, so an agent has everything needed to call and interpret it.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, so the schema already carries per-parameter meaning (baseline 3). The description nonetheless adds useful cross-parameter logic: pass the billing code if available, otherwise the plain-words service in q, and the city-vs-rest-of-state and hospital-vs-doctor fallback behavior. That is a genuine increment over the structured fields.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description states a specific verb and resource ('Compare a charge with Medicare's rate for one service') and the 'one service' scope implicitly separates it from the sibling check_whole_bill. An agent can identify the tool and its granularity without opening the schema.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

It gives a clear triggering condition ('when someone asks whether a charge is high or what Medicare pays') plus two concrete example questions, which is strong when-to-use guidance. It does not name an alternative such as check_whole_bill or state when not to use it, so it falls short of the explicit alternatives-routing seen in top-scoring definitions.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

Try in Browser

Glama MCP Gateway

Add one secure layer between your agents and this server.