specification: API Commons Rate Limits
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/RateLimits
provider: Claim.MD
providerId: claim-md
created: '2026-06-21'
modified: '2026-06-21'
reconciled: false
tags:
- Healthcare
- Medical Claims
- Clearinghouse
- EDI
- X12
- Rate Limiting
- Quotas
- Throttling
description: >-
  The Claim.MD API documents a request rate ceiling of 100 requests per minute
  per account, with a batch claim file allowed to contain between 1 and 2000
  claims per upload call. The claim status response endpoint returns a maximum
  of 20,000 results per request and is designed for incremental polling via
  ResponseID. Real-time eligibility is one request per 270 file (no batch
  real-time submission). Specific throttling response codes are not reconciled
  in this artifact.
notes: >-
  Verify current limits in the Claim.MD API documentation during reconciliation;
  observe the documented 100 requests/minute ceiling and use incremental
  ID-based polling rather than tight loops.
sources:
- https://docs.claim.md/docs/api
- https://docs.claim.md/docs/api-related-faqs
- https://docs.claim.md/docs/does-the-claimmd-api-support-batch-real-time-eligibility-requests
limits:
- name: Requests Per Minute
  scope: account
  metric: requests
  limit: 100
  notes: API calls should not exceed 100 requests per minute per account.
- name: Claims Per Upload
  scope: request
  metric: claims
  limit: 2000
  notes: A single claim file upload may contain between 1 and 2000 claims.
- name: Response Results Per Request
  scope: request
  metric: results
  limit: 20000
  notes: The /services/response/ endpoint returns at most 20,000 results per call.
- name: Eligibility Requests
  scope: request
  metric: requests
  limit: 1
  notes: One eligibility request per 270 file; no batch real-time eligibility submission.
policies:
- name: Incremental Polling
  description: >-
    Use last-seen identifiers (ResponseID, ERAID, ModID, NoteID) to retrieve
    only new records rather than repolling the full dataset.
- name: Pagination
  description: >-
    List endpoints (uploadlist, eralist) support Page-based pagination for
    large result sets.
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com