VerityVerity 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.

What Verity does

Medicare coverage policies are scattered across thousands of PDFs from different contractors. Finding them means digging through payer portals, reading dense policy documents, and manually tracking changes.

Verity solves this. We extract coverage criteria, prior auth requirements, and code coverage from LCDs, Articles, and NCDs. You get clean JSON instead of unstructured PDFs.

Installation

We built SDKs for the languages developers actually use:

pip install verity-python

View Python docs →

npm install verity-api

View TypeScript docs →

# Download binary - no runtime needed
go install github.com/tylerbryy/verity-cli@latest

View Go docs →

dotnet add package Verity.SDK

View .NET docs →

Get your API key from the Developer Console.

Your first request

from verity import VerityClient

client = VerityClient(api_key="vrt_live_YOUR_API_KEY")

# Look up a code with RVU data and policies
result = client.lookup_code(code="76942", include=["rvu", "policies"])

print(result["data"]["description"])
# "Echo guide for biopsy"

print(f"Facility price: ${result['data']['rvu']['facility_price']}")
# "Facility price: $64.13"

print(f"Found {len(result['data']['policies'])} coverage policies")
# "Found 16 coverage policies"
import { VerityClient } from 'verity-api';

const client = new VerityClient('vrt_live_YOUR_API_KEY');

// Look up a code with RVU data and policies
const result = await client.lookupCode({
  code: '76942',
  include: ['rvu', 'policies']
});

console.log(result.data.description);
// "Echo guide for biopsy"

console.log(`Facility price: $${result.data.rvu?.facility_price}`);
// "Facility price: $64.13"

console.log(`Found ${result.data.policies?.length} coverage policies`);
// "Found 16 coverage policies"
export VERITY_API_KEY=vrt_live_YOUR_API_KEY

# Look up a code with RVU data and policies
verity check 76942 --rvu --policies

# Output:
# Code: 76942
# Description: Echo guide for biopsy
# Facility Price: $64.13
# Found 16 coverage policies
curl -X GET "https://verity.backworkai.com/api/v1/codes/lookup?code=76942&include=policies" \
  -H "Authorization: Bearer vrt_live_YOUR_API_KEY"

Common scenarios

Check if a procedure needs prior auth

result = client.check_prior_auth(
    procedure_codes=["27447"],  # Total knee replacement
    diagnosis_codes=["M17.11"],  # Osteoarthritis, right knee
    state="TX"
)

if result["data"]["pa_required"]:
    print(f"Prior authorization required. Confidence: {result['data']['confidence']}")
    print(f"Documentation needed: {', '.join(result['data']['documentation_checklist'][:3])}")
else:
    print("No prior authorization needed")

The API returns structured criteria, not vague yes/no answers. You get the specific documentation requirements and confidence levels.

Search policies across jurisdictions

Medicare coverage varies by MAC jurisdiction. A procedure covered in Texas might not be covered in Pennsylvania.

result = client.compare_policies(
    procedure_codes=["76942"],
    jurisdictions=["J05", "J06", "JM"]
)

for juris in result["data"]["comparison"]:
    print(f"{juris['jurisdiction']} ({juris['mac_name']}): {len(juris['policies'])} policies")

Monitor policy changes

Policies change constantly. Verity tracks updates across all 19,000+ policies.

from datetime import datetime, timedelta

seven_days_ago = (datetime.now() - timedelta(days=7)).isoformat() + "Z"

result = client.get_policy_changes(since=seven_days_ago, limit=20)

for change in result["data"]:
    print(f"{change['policy_id']}: {change['change_type']} - {change['change_summary']}")

What you get

Structured data
Coverage criteria, codes, and requirements as JSON. No PDF parsing required.

Multi-jurisdiction coverage
Medicare coverage varies by contractor. We handle all 15 MAC jurisdictions.

Real-time updates
Policies change frequently. We track them all and surface changes via API.

AI-extracted criteria
Coverage requirements extracted from PDFs by AI, validated for accuracy.

Limitations

Verity focuses on Medicare coverage policies (LCDs, Articles, NCDs). We don't currently support:

  • Commercial payer policies (coming soon for major payers)
  • State Medicaid policies
  • Pharmacy benefit management rules

The API returns what's in the policies. It doesn't make coverage decisions for you.

Next steps


Resources

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