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Med Bill Check

Compare a charge with Medicare's rate for one service

check_price
Read-onlyIdempotent

Compare a charge with Medicare's rate for one service. Use 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?". Pass 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.
settingNooffice (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. First observed

TDQS

A4.8/5.0
Behavior5/5

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

Annotations cover the safety profile (readOnly, idempotent, non-destructive), and the description goes well beyond them: it names the returned fields (medicare_2026, hospital_facility_2026, comparison.compared_with), explains the city-vs-rest-of-state pricing switch, and discloses the dental 404 with a redirect. That is substantive behavioral context for a tool with no output schema.

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?

Front-loaded with purpose and when-to-use before the longer return-value explanation. Dense and information-rich, though the final sentence runs long with several nested field names; nothing is wasted, but it is not maximally crisp.

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 and no required parameters, the description carries the full burden of explaining what comes back and how the comparison is framed, and it does so thoroughly, including edge cases and non-US inputs.

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 coverage is 100%, so the baseline is 3, but the description adds cross-parameter logic the schema lacks: pass code if available, otherwise plain words as q, and it explains that omitted billed_by compares against both hospital and doctor amounts.

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?

States a specific verb+resource+scope: 'Compare a charge with Medicare's rate for one service.' The 'one service' scope cleanly distinguishes it from the sibling check_whole_bill, and the title reinforces it.

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

Usage Guidelines5/5

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

Gives explicit triggering conditions with two realistic example queries ('I was charged $450 for a 99213...', 'what does Medicare pay for an MRI of the knee?'), plus fallback guidance for missing codes and non-Medicare cases (dental 404, UK bills). An agent knows when to reach for this tool.

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

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