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-pythonnpm install verity-api# Download binary - no runtime needed
go install github.com/tylerbryy/verity-cli@latestdotnet add package Verity.SDKGet 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 policiescurl -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
Python SDK
Idiomatic Python with type hints
TypeScript SDK
Full TypeScript support for Node.js and browser
Go CLI
Single binary command-line tool
.NET SDK
C# SDK with async/await
Resources
- API Reference - All endpoints
- Authentication - API keys and security
- Rate Limits - Usage limits
- Error Handling - Handle errors gracefully