specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: Centene
providerId: centene
created: '2026-05-04'
# Provenance stamped 2026-08-11: this artifact was written by the API Evangelist
# bulk sweep dated 2026-05-04, not harvested from the provider. See roadmap#35.
method: generated
modified: '2026-05-05'
reconciled: false
tags:
  - Healthcare
  - FHIR
  - CMS Interoperability
  - Patient Access
  - Provider Directory
description: Centene's developer portal at partners.centene.com publishes three FHIR-based interoperability
  APIs (Patient Access, Provider Directory, and Provider RTR / PDEX Directory) that exist to satisfy
  the 21st Century Cures Act and the CMS Interoperability and Patient Access Rule. These regulator-mandated
  APIs do not charge a fee — third-party developers register an application and receive read access
  on behalf of authorized members or the public, with no commercial pricing tier.
notes: CMS-mandated FHIR APIs are free to authorized third-party developers. Centene does not publish
  a paid tier on the partner portal.
sources:
  - https://partners.centene.com/apis
  - https://partners.centene.com/applicationDeveloper
  - https://www.superiorhealthplan.com/members/medicaid/resources/interoperability-and-patient-access/interoperability-for-developers.html
plans:
  - id: centene-fhir-public
    name: CMS Interoperability FHIR APIs (Free)
    type: freemium
    description: Free regulator-mandated read access to Centene's FHIR Patient Access, Provider Directory,
      and Provider RTR / PDEX Directory APIs. Patient Access requires SMART-on-FHIR member authorization;
      Provider Directory is unauthenticated public; PDEX is restricted to authorized payers.
    entries:
      - label: Patient Access (SMART-on-FHIR member auth)
        name: patient_access
        type: quota
        metric: request
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
      - label: Provider Directory (public)
        name: provider_directory
        type: quota
        metric: request
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
      - label: Provider RTR / PDEX (authorized payer)
        name: pdex_rtr
        type: quota
        metric: request
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
    elements:
      - name: SMART-on-FHIR app registration
      - name: HL7 FHIR R4 resources
      - name: PDEX provider directory profiles
      - name: 21st Century Cures Act compliance
      - name: CMS Interoperability and Patient Access Rule compliance
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com