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ProviderSignal Medicaid Fee Schedule API
x402
ProviderSignal Medicaid Fee Schedule API is a paid API for AI agents from providersignal.com, paid per call via x402, $0.5/call, status unknown (last checked 2026-09-14).
Returns US Medicaid fee-for-service reimbursement rates for procedure codes across all 50 states, with cross-state comparisons and category-level statistics
Price / call$0.5
Success—
StatusUnknown
How this service works
Healthcare market intelligence API. Unified provider directory + acquisition signals + license-events feed across all 50 US states, derived from NPI + state dental boards + CMS Medicare + OIG LEIE + state Medicaid + HRSA HPSA designations. All responses ship a citation envelope (`meta.envelope_version`, `meta.source_attribution`, `meta.request`) so agents can verify source freshness without out-of-band validation. Paid `/api/v1/agent/*` endpoints accept two per-call rails on a single 402: x402 (USDC on Base mainnet) and MPP (Stripe card via a Shared Payment Token), plus Bearer-token subscription auth for existing API keys. See [/docs/agent-payments](/docs/agent-payments) for the full flow. See [/docs/fields](/docs/fields) for the field glossary and [/llms.txt](/llms.txt) for the LLM crawler index.
Output
Returns structured data with mode-specific fields: for code lookups, a per-state list with benchmark_rate, pct_of_medicare, effective_year, pa_status, and is_bare flags; for state+category queries, aggregate stats including total codes, count requiring prior auth, and median pct_of_medicare. All responses include a citation envelope with source attribution and envelope version for auditability.
Example use cases
Cross-state reimbursement benchmarking for a procedure
“Can you pull the Medicaid fee schedule for CPT code 99213 across all states and show me the benchmark rates and what percentage of Medicare each one pays?”
State category stats for contract negotiation
“I need Medicaid fee schedule stats for physician services in Texas — how many codes are covered, how many require prior auth, and what's the median rate relative to Medicare?”
Prior auth burden analysis for a specific code
“Which states require prior authorization for HCPCS code E0601, and what are the Medicaid benchmark rates where it's covered?”
Technical details
Endpoint
GEThttps://providersignal.com/api/v1/agent/medicaid/fee-scheduleWhen to prefer
Use this endpoint when you need authoritative, cross-state Medicaid fee-for-service reimbursement data with source citations — particularly for benchmarking a specific CPT/HCPCS code against Medicare, auditing prior authorization requirements by state, or analyzing category-level fee schedule statistics. Prefer this over manual state lookups when you need structured, machine-readable data with freshness metadata across all 50 states in a single call.
Side effects
- Invalid CPT/HCPCS code format (must match ^[A-Z0-9-]{3,7}$) returns validation error
- Invalid 2-letter state code returns error
- Requesting category stats without providing a state returns error
- Code not found in any state Medicaid schedule returns empty states array
- 402 Payment Required if no valid x402 USDC payment or MPP token or Bearer subscription key is provided
- Rate data may be missing (null benchmark_rate) for states that publish bare schedules without dollar amounts
Input
Schema · Request body
| Field | Type | Description |
|---|---|---|
| inputrequired | object | |
| output | object |
Output
Schema · Response
{
"type": "json",
"example": {
"data": {
"code": "99213",
"mode": "code_compare",
"label": "Office visit, established patient, low complexity (20-29 min)",
"states": [
{
"state": "CA",
"is_bare": true,
"pa_status": null,
"benchmark_rate": 82.02,
"effective_year": 2026,
"pct_of_medicare": 86.2
},
{
"state": "TX",
"is_bare": false,
"pa_status": null,
"benchmark_rate": 33.95,
"effective_year": 2026,
"pct_of_medicare": 35.7
}
],
"disclaimer": "Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Absence of a PA flag means the state does not publish one."
},
"meta": {
"request": {
"endpoint": "/api/v1/agent/medicaid/fee-schedule",
"billing_method": "per_query"
},
"envelope_version": "1.0"
},
"error": null
}
}Tags
x402
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