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MyMedi-AI

mymedi-ai-mcp-server

by MyMedi-AI

Medicare national payment rate (free)

reimbursement_basic
Read-onlyIdempotent

Look up Medicare reimbursement for a CPT/HCPCS or DME code, returning national PFS facility and non-facility payments plus current DMEPOS fee ranges.

Instructions

Look up Medicare payment for a code. Returns the national facility and non-facility payment under the current Medicare PFS (CMS RVU × conversion factor) for professional services, plus ranges from the current CMS DMEPOS fee schedule quarter (rental/purchase, min–max across state fees) for DME items like E/K/L codes. Free, no API key required.

Input Schema

NameRequiredDescriptionDefault
codeYesMedical code (e.g., "97110" or "E1390")

Schema Changelog

Changes observed during successful MCP inspections.

  1. Addedv1.7.9

TDQS

A3.8/5.0
Behavior4/5

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

Annotations already declare readOnlyHint, idempotentHint, destructiveHint=false and openWorldHint=false, so the safety profile is covered. The description adds genuinely non-structured context: the data provenance (CMS PFS RVU x conversion factor, current DMEPOS fee schedule quarter), that DMEPOS results are state-fee ranges, and that no API key is needed. It does not state error behavior for unknown codes or the currency/units, which keeps it short of a 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?

Two sentences, front-loaded with the purpose, with the formula parentheticals earning their place by establishing data provenance. The second sentence is dense and long, but every clause conveys distinct information about what is returned.

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?

No output schema exists, so the description must carry the return-value burden, and it does: facility vs non-facility amounts, rental/purchase ranges, and min–max across state fees. Missing details are minor (currency, behavior on invalid/unsupported codes, whether state-level lookup lives in a sibling tool).

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?

With one parameter at 100% schema coverage, the schema already documents 'code'. The description still adds meaning by clarifying that the single input accepts both professional service codes (CPT-style) and DME items like E/K/L codes, and that the returned metric differs by code family. That is useful beyond the schema's bare example.

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

Purpose4/5

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

States a specific verb and resource ('Look up Medicare payment for a code') and names the two payment families it covers (PFS professional and DMEPOS). It does not explicitly differentiate itself from sibling tools like code_reimbursement or fee_schedule_lookup, so an agent must infer from 'national' and 'basic' naming which sibling to pick.

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?

Usage is implied rather than stated: the agent learns it is for Medicare payment on a code and that DME E/K/L codes are in scope. 'Free, no API key required' is a useful selection signal against paid siblings such as code_reimbursement, but there is no explicit when-to-use / when-not-to-use / alternative-tool routing.

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