Verity API

Quickstart

Get started with the Verity API for Medicare coverage intelligence

Verity gives you instant access to 19,000+ Medicare coverage policies as structured, searchable data

Welcome to Verity

Verity is an API that provides structured Medicare coverage policy intelligence. We extract and structure coverage criteria, prior auth requirements, and code coverage from LCDs, Articles, and NCDs - so you don't have to.

How to use it?

We provide an easy-to-use REST API. You can find the playground and documentation here.

Check out the following resources to get started:

API Key

To use the API, you need to sign up and get an API key from the Developer Console.

Features

  • Code Lookup: Look up coverage for any CPT, HCPCS, or ICD-10 code
  • Policy Search: Search 19,000+ Medicare policies by keyword or semantically
  • Prior Auth Check: Check if prior authorization is required for a procedure
  • Coverage Criteria: Get structured indications, limitations, and documentation requirements
  • Policy Changes: Monitor policy updates in real-time

Powerful Capabilities

  • Structured data: Coverage criteria, codes, and requirements as JSON
  • Multi-jurisdiction: Coverage varies by MAC - we handle the complexity
  • Real-time updates: Policies change frequently - we track it all
  • AI-extracted: Criteria extracted by AI, validated for accuracy

Making Your First Request

import requests

API_KEY = "vrt_live_YOUR_API_KEY"
BASE_URL = "https://api.verity.health/v1"

response = requests.get(
    f"{BASE_URL}/health",
    headers={"Authorization": f"Bearer {API_KEY}"}
)
print(response.json())
const API_KEY = 'vrt_live_YOUR_API_KEY';
const BASE_URL = 'https://api.verity.health/v1';

const response = await fetch(`${BASE_URL}/health`, {
  headers: {
    'Authorization': `Bearer ${API_KEY}`
  }
});
const data = await response.json();
console.log(data);
curl -X GET "https://api.verity.health/v1/health" \
  -H "Authorization: Bearer vrt_live_YOUR_API_KEY"

Code Lookup

Look up coverage policies for any procedure code:

import requests

response = requests.get(
    'https://api.verity.health/v1/codes/lookup',
    params={'code': '76942', 'include': 'policies'},
    headers={'Authorization': 'Bearer vrt_live_YOUR_API_KEY'}
)
print(response.json())
const params = new URLSearchParams({
  code: '76942',
  include: 'policies'
});

const response = await fetch(
  `https://api.verity.health/v1/codes/lookup?${params}`,
  {
    headers: {
      'Authorization': 'Bearer vrt_live_YOUR_API_KEY'
    }
  }
);
const data = await response.json();
console.log(data);
curl -X GET "https://api.verity.health/v1/codes/lookup?code=76942&include=policies" \
  -H "Authorization: Bearer vrt_live_YOUR_API_KEY"

Response

{
  "success": true,
  "data": {
    "code": "76942",
    "code_system": "HCPCS",
    "display": "Ultrasonic guidance for needle placement",
    "policies": [
      {
        "policy_id": "L33345",
        "title": "Ultrasound Guidance for Needle Placement",
        "policy_type": "LCD",
        "jurisdiction": "JM",
        "disposition": "covered"
      }
    ],
    "coverage_summary": {
      "total_policies": 15,
      "covered": 12,
      "not_covered": 1,
      "conditional": 2
    }
  }
}

Prior Authorization Check

Check if prior auth is required for a procedure:

import requests
import uuid

response = requests.post(
    'https://api.verity.health/v1/prior-auth/check',
    headers={
        'Authorization': 'Bearer vrt_live_YOUR_API_KEY',
        'X-Idempotency-Key': str(uuid.uuid4())
    },
    json={
        'procedure_codes': ['76942'],
        'state': 'TX'
    }
)
print(response.json())
const response = await fetch('https://api.verity.health/v1/prior-auth/check', {
  method: 'POST',
  headers: {
    'Authorization': 'Bearer vrt_live_YOUR_API_KEY',
    'Content-Type': 'application/json',
    'X-Idempotency-Key': crypto.randomUUID()
  },
  body: JSON.stringify({
    procedure_codes: ['76942'],
    state: 'TX'
  })
});
const data = await response.json();
console.log(data);
curl -X POST "https://api.verity.health/v1/prior-auth/check" \
  -H "Authorization: Bearer vrt_live_YOUR_API_KEY" \
  -H "Content-Type: application/json" \
  -H "X-Idempotency-Key: $(uuidgen)" \
  -d '{
    "procedure_codes": ["76942"],
    "state": "TX"
  }'

Response

{
  "success": true,
  "data": {
    "pa_required": false,
    "confidence": "high",
    "matched_policies": ["L33345", "L38624"],
    "documentation_checklist": [
      "Medical necessity documentation",
      "Prior imaging results"
    ]
  }
}

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