PA/WOPD catalog exposure report (up to 100 codes)
pa_exposure_reportMap supplier HCPCS codes to CMS prior authorization and face-to-face/written-order requirements, returning per-code compliance flags and catalog-level denial-risk exposure.
Instructions
Map a supplier HCPCS catalog against the current CMS Required Prior Authorization List and Required Face-to-Face Encounter & Written Order Prior to Delivery List on a date of service (default today). Per code: PA requirement and the date it applies from, F2F/WOPD requirement, documentation gates (SWO, UTN-before-claim, F2F/WOPD sequencing), and deterministic denial-risk flags — plus a catalog-level exposure summary. Some items are phased in by state: with a state the answer is definitive; without one they are reported as required in some states (paRequiredInSomeStates). Unknown or non-HCPCS codes are flagged and count as billable answers. Priced per code — $0.01 × number of codes, max 100 per call. Returns JSON. Original Medicare FFS scope. PHI-free: codes in, rules out.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| codes | Yes | Supplier catalog HCPCS codes, e.g. ["E0651", "L0651", "K0856"] (1-100 per call) | |
| state | No | 2-letter US state or territory; needed for items phased in by state | |
| dateOfService | No | Date of service, YYYY-MM-DD (default today) |