Claude CMS Coverage connectorWhat Claude can do in your CMS Coverage account.
The Claude CMS Coverage connector exposes 8 tools: 8 for reading, 0 for writing. They query the Medicare Coverage Database for Part B policies. Below: what Claude can look up, what it leaves out, and the licence terms you accept by connecting.
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What changes for coders, billers and compliance teams
Checking whether Medicare pays for a procedure normally means digging through the CMS database by hand, then cross-reading a policy and its billing article. With this connector, Claude runs those searches itself while it answers, opens the full policy, and lays out criteria, codes and dates in plain language.
Know before the service. A clinic wants to confirm coverage for a device: search_ncds looks for a nationwide decision, search_lcds for the regional policy of the relevant contractor, and get_ncd pulls the complete document with indications, limitations and documentation requirements.
Bill it right. A coder needs the CPT/HCPCS codes and ICD-10 requirements for a service: search_articles finds the billing and coding article that goes with the policy.
Stay ahead of changes. A compliance officer opens the week with whats_new_national to see national policy updates, and search_nca_cals to follow coverage analyses still in progress.
What it does not do: it covers Part B only, so no Part D drug formularies and no Part A inpatient coverage. It changes nothing anywhere, since the database is a public reference you consult. It also does not watch anything for you; no alert fires when a policy moves. Ongoing monitoring of that kind is the job of automation tools, listed from the Integrations hub.
Five words before you plug it in
The terms you will see in Claude's settings and on this page.
- Connector
- The link you set up once between Claude and a source you rely on, so Claude can use it while it answers what you ask.
- Tool
- One named action the connector gives Claude. Claude picks the ones it needs on its own; the directory sheet lists each of them by name.
- Authorization
- The service's own sign-in screen, where you grant Claude the access it will use. Granted once per person, and it can be withdrawn the same way.
- Approval
- The confirmation Claude waits for in the chat before carrying out any action that changes an account on your behalf.
- MCP
- The shared standard behind connectors: it is what lets an assistant such as Claude exchange with an outside service at all.
Plug CMS Coverage into Claude in three steps
- 01
Open the connector list
Anthropic's own tutorial for this connector starts in Settings, then Connectors. Scroll or search until CMS Coverage appears in the list of available connectors.
- 02
Connect it
Click Connect on the CMS Coverage entry. The tutorial notes that the integration relies on Claude's support for remote connectors, so it runs from Claude itself rather than from a file on your computer.
- 03
Workspace owners go first
On Team and Enterprise, an owner opens Admin settings, then Connectors, and clicks Browse connectors. From there the owner picks this connector and chooses Add to your team, after which members can connect.
The 8 tools, sorted by what they do
CMS Coverage gives Claude 8 tools: 8 that read your account, 0 that change something in it.
Every tool reads. The names stay in English, exactly as Claude shows them, in the order of the directory sheet.
- 8 read
What Claude reads (8)
8 toolsEight tools that search or retrieve Medicare Part B coverage information.
get_contractors
Identifies the Medicare Administrative Contractors, the regional bodies known as MACs, that handle a given area. The tutorial presents it as the way to identify contractors by region.
get_ncd
Retrieves the complete text of a National Coverage Determination, with its coverage criteria, indications, limitations, effective dates and documentation requirements, rather than a summary of it.
sad_exclusion_list
Looks up the self-administered drug exclusion list, so Claude can check whether a drug appears among the self-administered exclusions before you bill it.
search_articles
Finds the detailed billing guidance attached to coverage policies: CPT and HCPCS codes, ICD-10 diagnosis requirements and the other details a claim needs to go through cleanly.
search_lcds
Searches Local Coverage Determinations, the policies each Medicare Administrative Contractor publishes for its own region, so Claude can compare what applies in one area against another.
search_nca_cals
Searches national coverage analyses and the related letters, so you can follow where an analysis stands, straight from CMS's official repository.
search_ncds
Runs a search across the official nationwide coverage policies and returns the decisions that match a service, procedure or condition, ready to be opened in full afterwards.
whats_new_national
Lists what is new in national coverage policy, so Claude can tell you what moved since you last looked without you scanning the whole database.
What Claude asks before it acts
By default, Claude stops and asks for your go-ahead before any action it takes on an account in your place. With this connector that rarely matters: no source describes a write tool or a confirmation step.
On a Team or Enterprise workspace, owners decide whether members may let certain actions run without being asked each time, and they can cap what any connector may do for the whole organisation, keeping reading and closing writing for instance. That setting binds everyone. Claude only works with the rights of the person connected. The official read-only or write-delete label per tool appears only in a signed-in account's settings.
Which plans can use it
None of the 819 sheets in the official directory states availability by plan. That answer, connector by connector, is published nowhere, which is a genuine gap in the catalogue.
The general rule is public. Remote connectors are open to all users on Claude, Cowork, Claude Desktop and mobile; desktop extensions install on Claude Desktop. On Team and Enterprise, an Owner or Primary Owner enables a connector for the organisation before members can connect. For the live status of this one, open the CMS Coverage sheet in the official directory from your own account.
Where this connector stops
A connector is not an automation. Claude calls these tools while it answers you, and nothing starts on its own when a policy is published or revised.
By default the sheet exposes reading only, an observed floor rather than a guarantee. Anthropic publishes this connector itself, but even here the directory states that it cannot vouch for every tool behaving as announced. Two Anthropic sources also disagree on the list: the tutorial describes more tools than the sheet shows. The sheet is what Claude actually exposes, so this page sticks to its 8 tools. For a sheet read the same way, see the Claude affinity connector.
Need help connecting CMS Coverage to Claude?
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