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code_reimbursement

Retrieve Medicare reimbursement rates for medical codes. Returns RVU values and estimated payment amounts based on CMS PFS conversion factor.

Instructions

Look up Medicare reimbursement rates for a medical code. Returns RVU values and estimated payment amounts using CMS PFS conversion factor. Source: CMS PFS RVU 2026 (public domain).

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
codeYesMedical code (e.g., "99213", "M79.3")
codeTypeNoCode system (auto-detected if omitted)

Implementation Reference

  • The tool definition for 'code_reimbursement' including its name, description, price, endpoint, and Zod schema (code and codeType parameters).
    // --- Reimbursement Rates (CMS PFS — public domain) ---
    {
      name: 'code_reimbursement',
      description: 'Look up Medicare reimbursement rates for a medical code. Returns RVU values and estimated payment amounts using CMS PFS conversion factor. Source: CMS PFS RVU 2026 (public domain).',
      price: '$0.01',
      endpoint: '/agent/v1/codes/reimbursement',
      schema: {
        code: z.string().describe('Medical code (e.g., "99213", "M79.3")'),
        codeType: z.enum(['ICD10', 'CPT', 'HCPCS']).optional().describe('Code system (auto-detected if omitted)'),
      },
    },
  • src/index.js:19-61 (registration)
    The tool registration loop in createMcpServer() where 'code_reimbursement' is registered via s.tool(), with the generic async handler that fetches from the REST endpoint /agent/v1/codes/reimbursement.
    for (const tool of MCP_TOOLS) {
      s.tool(tool.name, tool.description, tool.schema, async (params) => {
        const toolDef = getToolByName(tool.name);
        if (!toolDef) {
          return { content: [{ type: 'text', text: `Unknown tool: ${tool.name}` }], isError: true };
        }
        try {
          const response = await fetch(`${API_BASE_URL}${toolDef.endpoint}`, {
            method: 'POST',
            headers: {
              'Content-Type': 'application/json',
              ...(API_KEY && { 'X-API-Key': API_KEY }),
              'X-Agent-ID': 'mcp-client',
              'User-Agent': '@mymedi-ai/mcp-server/1.2.1',
            },
            body: JSON.stringify(params),
          });
          if (response.status === 402) {
            const paymentInfo = await response.json();
            return {
              content: [{ type: 'text', text: JSON.stringify({
                error: 'payment_required',
                message: `This tool costs ${toolDef.price} per call. Register at ${API_BASE_URL}/bot-marketplace/register for an API key with 10 free starter credits, or pay per call with on-chain USDC (no signup) via the x402 protocol.`,
                price: toolDef.price, register: `${API_BASE_URL}/bot-marketplace/register`, ...paymentInfo,
              }, null, 2) }], isError: true,
            };
          }
          if (!response.ok) {
            const error = await response.json().catch(() => ({ message: response.statusText }));
            return { content: [{ type: 'text', text: JSON.stringify({ error: true, status: response.status, ...error }, null, 2) }], isError: true };
          }
          const data = await response.json();
          const creditsSpent = response.headers.get('X-Credits-Spent');
          const creditsRemaining = response.headers.get('X-Credits-Remaining');
          if (creditsSpent) {
            data._billing = { creditsSpent: parseInt(creditsSpent, 10), creditsRemaining: creditsRemaining ? parseInt(creditsRemaining, 10) : undefined, priceUSD: toolDef.price };
          }
          return { content: [{ type: 'text', text: JSON.stringify(data, null, 2) }] };
        } catch (err) {
          return { content: [{ type: 'text', text: JSON.stringify({ error: true, message: err.message, hint: 'Ensure MCP_API_BASE_URL and MCP_API_KEY environment variables are set.' }, null, 2) }], isError: true };
        }
      });
    }
  • src/index.js:68-72 (registration)
    The sandbox registration in createSandboxServer() where 'code_reimbursement' is registered with a generic sandbox handler.
    for (const tool of MCP_TOOLS) {
      sandboxServer.tool(tool.name, tool.description, tool.schema,
        async () => ({ content: [{ type: 'text', text: 'sandbox' }] }));
    }
    return sandboxServer;
  • The generic async handler used for all tools including code_reimbursement. It sends a POST request to the tool's endpoint (here /agent/v1/codes/reimbursement) with the params, handles x402 payment-required (402) responses, error responses, and attaches billing info from response headers.
    s.tool(tool.name, tool.description, tool.schema, async (params) => {
      const toolDef = getToolByName(tool.name);
      if (!toolDef) {
        return { content: [{ type: 'text', text: `Unknown tool: ${tool.name}` }], isError: true };
      }
      try {
        const response = await fetch(`${API_BASE_URL}${toolDef.endpoint}`, {
          method: 'POST',
          headers: {
            'Content-Type': 'application/json',
            ...(API_KEY && { 'X-API-Key': API_KEY }),
            'X-Agent-ID': 'mcp-client',
            'User-Agent': '@mymedi-ai/mcp-server/1.2.1',
          },
          body: JSON.stringify(params),
        });
        if (response.status === 402) {
          const paymentInfo = await response.json();
          return {
            content: [{ type: 'text', text: JSON.stringify({
              error: 'payment_required',
              message: `This tool costs ${toolDef.price} per call. Register at ${API_BASE_URL}/bot-marketplace/register for an API key with 10 free starter credits, or pay per call with on-chain USDC (no signup) via the x402 protocol.`,
              price: toolDef.price, register: `${API_BASE_URL}/bot-marketplace/register`, ...paymentInfo,
            }, null, 2) }], isError: true,
          };
        }
        if (!response.ok) {
          const error = await response.json().catch(() => ({ message: response.statusText }));
          return { content: [{ type: 'text', text: JSON.stringify({ error: true, status: response.status, ...error }, null, 2) }], isError: true };
        }
        const data = await response.json();
        const creditsSpent = response.headers.get('X-Credits-Spent');
        const creditsRemaining = response.headers.get('X-Credits-Remaining');
        if (creditsSpent) {
          data._billing = { creditsSpent: parseInt(creditsSpent, 10), creditsRemaining: creditsRemaining ? parseInt(creditsRemaining, 10) : undefined, priceUSD: toolDef.price };
        }
        return { content: [{ type: 'text', text: JSON.stringify(data, null, 2) }] };
      } catch (err) {
        return { content: [{ type: 'text', text: JSON.stringify({ error: true, message: err.message, hint: 'Ensure MCP_API_BASE_URL and MCP_API_KEY environment variables are set.' }, null, 2) }], isError: true };
      }
    });
  • The getToolByName helper function used to look up tool definitions, including code_reimbursement, by name.
    export function getToolByName(name) {
      return MCP_TOOLS.find((t) => t.name === name);
    }
Behavior4/5

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

No annotations are provided, so the description carries the full burden. It discloses the source (CMS PFS RVU 2026) and output (RVU values, estimated payment amounts). It implies a read-only operation ('Look up') but does not explicitly state idempotency or limitations.

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

Conciseness5/5

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

Two sentences, no wasted words. Front-loaded with purpose, followed by source and output details. Each sentence earns its place.

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

Completeness4/5

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

The tool has 2 parameters and no output schema. The description sufficiently explains the output and data source. It could mention error handling or precision, but it is generally complete for a simple lookup tool.

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

Parameters3/5

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

Schema description coverage is 100%, with both parameters documented. The description adds no new parameter details beyond what the schema already provides (including auto-detection for codeType). Baseline 3 is appropriate.

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 clearly states the tool looks up Medicare reimbursement rates for a medical code, with specific verb 'look up' and resource 'Medicare reimbursement rates'. It distinguishes from sibling tools like code_lookup (general) and code_crossref (cross-referencing) by focusing on reimbursement.

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

Usage Guidelines3/5

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

The description does not explicitly state when to use this tool versus alternatives like code_lookup or code_suggest. While the purpose is clear, there is no guidance on exclusions or prerequisites.

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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