aid: centers-for-medicare-and-medicaid-services url: https://raw.githubusercontent.com/api-evangelist/centers-for-medicare-and-medicaid-services/refs/heads/main/apis.yml name: Centers for Medicare and Medicaid Services tags: - BCDA - Blue Button - CMS - Claims - DPC - FHIR - Federal Government - Healthcare - Interoperability - Marketplace - Medicaid - Medicare - Open Data - Provider Data - Socrata type: Index image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg access: 3rd-Party created: '2024-12-03' modified: '2026-05-19' position: Consumer specificationVersion: '0.19' description: >- The Centers for Medicare and Medicaid Services (CMS) is the federal agency that provides health coverage to more than 160 million Americans through Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. CMS operates one of the largest public API programs in the U.S. government, including the FHIR-based Blue Button 2.0, Beneficiary Claims Data API (BCDA), and Data at the Point of Care (DPC); the data.cms.gov Socrata Open Data API covering Medicare claims, provider, and enrollment datasets; the Medicare Provider Data Catalog (Hospital Compare, Nursing Home Compare); the Healthcare.gov Marketplace API; NPPES and NPI Registry APIs; the QPP Measures API; and Medicaid Transformed Medicaid Statistical Information System (T-MSIS) resources. apis: - aid: centers-for-medicare-and-medicaid-services:cms-blue-button-2 name: CMS Blue Button 2.0 API tags: - Blue Button - Claims - FHIR - Medicare - OAuth 2.0 - Patient Access humanURL: https://bluebutton.cms.gov/ baseURL: https://api.bluebutton.cms.gov/v2/fhir/ properties: - url: https://bluebutton.cms.gov/ type: Website - url: https://bluebutton.cms.gov/developers/ type: Developer - url: https://bluebutton.cms.gov/api-documentation/ type: Documentation - url: https://sandbox.bluebutton.cms.gov/ type: Sandbox - url: https://bluebutton.cms.gov/resources/ type: Resources - type: OpenAPI url: openapi/centers-for-medicare-and-medicaid-services-cms-blue-button-2-openapi.yml description: >- Blue Button 2.0 is a standards-based HL7 FHIR R4 API that delivers Medicare Part A, B, and D claims data for over 60 million beneficiaries to registered third-party applications, authorized by the beneficiary through OAuth 2.0. It anchors CMS's Patient Access API program under the 21st Century Cures Act. - aid: centers-for-medicare-and-medicaid-services:cms-bcda name: CMS Beneficiary Claims Data API (BCDA) tags: - ACO - BCDA - Bulk FHIR - Claims - Medicare - Shared Savings humanURL: https://bcda.cms.gov/ baseURL: https://api.bcda.cms.gov/api/v2/ properties: - url: https://bcda.cms.gov/ type: Website - url: https://bcda.cms.gov/guide.html type: Documentation - url: https://sandbox.bcda.cms.gov/ type: Sandbox description: >- The Beneficiary Claims Data API (BCDA) is a Bulk FHIR API that delivers Medicare Part A, B, and D claims data to Medicare Shared Savings Program ACOs, ACO REACH participants, and other Alternative Payment Model participants for their attributed and assignable beneficiaries. - aid: centers-for-medicare-and-medicaid-services:cms-dpc name: CMS Data at the Point of Care (DPC) API tags: - Bulk FHIR - Claims - FFS - Point of Care - Providers humanURL: https://dpc.cms.gov/ baseURL: https://api.dpc.cms.gov/api/v1/ properties: - url: https://dpc.cms.gov/ type: Website - url: https://dpc.cms.gov/docs type: Documentation - url: https://sandbox.dpc.cms.gov/ type: Sandbox - url: https://dpc.cms.gov/faq type: FAQ description: >- Data at the Point of Care is a FHIR Bulk Data API that delivers Original Medicare claims data to fee-for-service providers for the patients currently under their care, enabling clinicians to see a patient's full Medicare history at the point of care. - aid: centers-for-medicare-and-medicaid-services:cms-socrata-open-data name: CMS Socrata Open Data API (data.cms.gov) tags: - Datasets - Medicare - Open Data - Provider Data - SODA - Socrata humanURL: https://data.cms.gov/ baseURL: https://data.cms.gov/data.json properties: - url: https://data.cms.gov/ type: Website - url: https://data.cms.gov/provider-data/docs type: Documentation - url: https://developer.cms.gov/data-cms/ type: Developer - url: https://data.cms.gov/data-api type: DataAPI description: >- data.cms.gov hosts hundreds of CMS datasets including Medicare Fee-for-Service utilization and payment data, Provider of Services files, Medicare Part B/D Prescriber summaries, Marketplace open enrollment data, and COVID-19 nursing home data, available via the data.cms.gov Data API (JSON) and the CMS Provider Data Catalog Socrata-compatible endpoints. - aid: centers-for-medicare-and-medicaid-services:cms-provider-data-catalog name: CMS Provider Data Catalog API (Care Compare) tags: - Care Compare - Dialysis Compare - Hospital Compare - Nursing Home Compare - Provider Data - Quality humanURL: https://data.cms.gov/provider-data/ baseURL: https://data.cms.gov/provider-data/api/1/ properties: - url: https://data.cms.gov/provider-data/ type: Website - url: https://data.cms.gov/provider-data/docs type: Documentation - url: https://data.cms.gov/provider-data/api/1/metastore/schemas/dataset/items type: Metastore description: >- The Provider Data Catalog API (formerly Hospital Compare) exposes the Medicare.gov Care Compare datasets including Hospital, Nursing Home, Home Health, Hospice, Physician, Long-Term Care Hospital, Inpatient Rehab, and Dialysis Facility quality measures as DCAT-based datasets with Datastore query endpoints. - aid: centers-for-medicare-and-medicaid-services:nppes-npi-registry name: NPPES NPI Registry API tags: - Credentialing - NPI - NPPES - Provider Identifier - Provider Registry humanURL: https://npiregistry.cms.hhs.gov/ baseURL: https://npiregistry.cms.hhs.gov/api/ properties: - url: https://npiregistry.cms.hhs.gov/ type: Website - url: https://npiregistry.cms.hhs.gov/api-page type: Documentation - url: https://npiregistry.cms.hhs.gov/help-api/ type: Help description: >- The NPPES NPI Registry API provides free public access to look up active National Provider Identifier records for individual and organizational healthcare providers, supporting FHIR-compatible JSON responses used widely in credentialing, directory, and claims validation workflows. - aid: centers-for-medicare-and-medicaid-services:healthcare-gov-marketplace name: Healthcare.gov Marketplace API tags: - ACA - Exchange - Marketplace - Plan Finder - QHP humanURL: https://www.healthcare.gov/developers/ baseURL: https://marketplace.api.healthcare.gov/api/v1/ properties: - url: https://www.healthcare.gov/developers/ type: Developer - url: https://github.com/CMSgov/marketplace-api-examples type: Examples - url: https://data.healthcare.gov/ type: OpenData description: >- The Healthcare.gov Marketplace API and accompanying Open Data Plan Finder exposes Qualified Health Plan (QHP) details, plan attributes, provider networks, and formularies for the Federally-Facilitated Marketplace states, enabling third-party plan comparison and enrollment experiences. - aid: centers-for-medicare-and-medicaid-services:qpp-measures-api name: CMS Quality Payment Program (QPP) Measures API tags: - MIPS - Measures - Quality - QPP - Value-Based humanURL: https://qpp.cms.gov/ properties: - url: https://qpp.cms.gov/ type: Website - url: https://cmsgov.github.io/qpp-measures-data/ type: Documentation - url: https://github.com/CMSgov/qpp-measures-data type: SourceCode description: >- The Quality Payment Program Measures Data repository and REST API publish machine-readable specifications of MIPS quality, promoting interoperability, improvement activities, and cost measures for each performance year, supporting vendor QPP submissions and analytics. - aid: centers-for-medicare-and-medicaid-services:medicare-coverage-database name: Medicare Coverage Database (MCD) API tags: - Coverage - LCD - MAC - NCD - Policy humanURL: https://www.cms.gov/medicare-coverage-database/ properties: - url: https://www.cms.gov/medicare-coverage-database/ type: Website - url: https://www.cms.gov/medicare-coverage-database/downloads/downloads.aspx type: Downloads description: >- The Medicare Coverage Database publishes National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), articles, and coding guidance used to determine Medicare coverage and reimbursement policies, distributed via downloadable datasets and JSON/CSV query endpoints. common: - type: Website url: https://www.cms.gov/ - type: Developer url: https://developer.cms.gov/ - type: OpenData url: https://data.cms.gov/ - type: ProviderData url: https://data.cms.gov/provider-data/ - type: BlueButton url: https://bluebutton.cms.gov/ - type: BCDA url: https://bcda.cms.gov/ - type: DPC url: https://dpc.cms.gov/ - type: NPPES url: https://npiregistry.cms.hhs.gov/ - type: Marketplace url: https://www.healthcare.gov/developers/ - type: QPP url: https://qpp.cms.gov/ - type: GitHubOrganization url: https://github.com/CMSgov - type: PrivacyPolicy url: https://www.cms.gov/privacy - type: Integrations url: https://www.cms.gov/marketplace/in-person-assisters/information-partners integrations: - name: Employer initiatives maintainers: - FN: Kin Lane email: kin@apievangelist.com