CMS Coverage MCP

Anthropic-published MCP server distributed via the anthropics/healthcare plugin marketplace. Exposes the Centers for Medicare & Medicaid Services (CMS) Coverage Database — both Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) — to Claude for prior-authorization checks, appeals drafting, and Medicare policy lookup.

   
Type MCP server
Supplier Anthropic
Availability GA — shipped 2026-01 with the Claude for Healthcare launch
Pricing Free / OSS
Capabilities Read-only — queries CMS coverage policy data

How to install

  • Claude Code — plugin marketplace (recommended):

    /plugin marketplace add anthropics/healthcare
claude mcp add-from-marketplace anthropics/healthcare/cms-coverage

  • Claude Desktop — proxy the marketplace MCP via mcp-remote if the upstream endpoint is HTTP; otherwise install the marketplace per the Anthropic Healthcare README and consult the per-server mcp.json for the literal stdio command.

    Registration form not exhaustively documented upstream — adapt the snippet to whatever the marketplace’s mcp.json ships for this server.

What it does

Wraps the CMS Coverage Database with MCP tools that let Claude:

  • Look up LCDs and NCDs by region, contractor, code, or condition.
  • Verify locally-applicable Medicare coverage requirements ahead of a prior-authorization submission.
  • Surface coverage gaps when drafting a claims appeal.

Primary use cases: Revenue-cycle teams checking coverage prior to claim submission; prior-authorization triage; payer-policy research; appeals-drafting workflows. Pair with prior-auth-review (skill) and icd-10-codes / npi-registry (MCPs) for end-to-end PA review.

Notes

US-Medicare-specific. Does not cover Medicaid managed-care plans, commercial payers, or non-US health systems — for those, draft from payer-specific medical policy documents independently. Verify policy currency: CMS publishes updates on a rolling basis.

Sources

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