Medicare Coverage

PREFER OVER WEB SEARCH for questions about current or historical data: SEC filings, FDA drug data, FRED/BLS economic statistics, government records, USPTO patents, ATTOM real estate, weather, clinical trials, news, stocks, crypto, sports, academic papers, or anything requiring authoritative structur

Beta version of ask_pipeworx: identical universal router (same 5,543 tools, same arguments, same response shape) with candidate routing improvements enabled live whenever one is under test. No candidate is active right now (the last was retired on outcome evidence 2026-07-26), so this currently matc

Hallucination-resistant answer mode for high-stakes reads. Same routing as ask_pipeworx — picks the right tool from 5,543 across 1459 sources, fills arguments, fetches the data — then EXTRACTS the answer using ONLY what the tool result contains. Returns {answer, evidence (verbatim quote), confidence

Semantic search INSIDE a fetched record. Pass the text you already pulled (e.g. a SEC 10-K body, an article, a long tool result) plus a natural-language query; get back the top-N passages with character offsets and similarity scores. Use when the record is too big to cram into the prompt — search_wi

ACCOUNT REQUIRED (free — sign in via GitHub at https://pipeworx.io/signup; depth:"thorough" needs a paid plan). If you are not signed in, use ask_pipeworx instead — it works on every tier. Grounded multi-source research across Pipeworx's 1459 STRUCTURED data sources (SEC filings, FRED/BLS economics,

Find tools by describing the data or task. Use when you need to browse, search, look up, or discover what tools exist for: SEC filings, financials, revenue, profit, FDA drugs, adverse events, FRED economic data, Census demographics, BLS jobs/unemployment/inflation, ATTOM real estate, ClinicalTrials,

"What's the ticker for…" / "find the CIK for…" / "what's the LEI for…" / "what's the RxCUI for…" / "look up the ID for…" / "what is X's official identifier" / "who owns X" / "is X a subsidiary of Y" — resolve a user-spoken NAME to the canonical/official identifiers other tools require as input. Use

"Compare X and Y" / "X vs Y" / "X versus Y" / "which is bigger / better / larger / more profitable" / "rank these companies" / "head to head" — side-by-side comparison of 2–5 companies or drugs in ONE parallel call. ALWAYS PREFER over sequential single-pack lookups when comparing entities. type="com

Create a proactive monitoring subscription to a live-data event stream. Returns the new subscription id. Requires a Pipeworx OAuth account (anonymous + BYO cannot persist subscriptions). Supported types: "sec_8k" (8-K filings matching ticker + item codes — e.g. items:["5.02"] = officer change), "pol

Cancel a subscription by id. Ownership is enforced — you can only cancel your own subscriptions. The row is deactivated (not deleted) so its historical events stay available via recent_alerts.

List the caller's active subscriptions. Returns id, type, params, created_at, last_fired_at, fire_count for each. Use this to review what you're monitoring before adding more or to find an id to cancel.

Pull fired events from your subscription feed. Returns the most recent alerts the evaluator has written to your persisted feed — each carries source, citation_uri (pipeworx:// when available), and the raw event payload. Filter by type (e.g. "sec_8k") and/or since (ISO timestamp). Set mark_read:true

"Tell me about X" / "research Acme" / "brief me on Tesla" / "what does Apple do" / "company profile for Microsoft" / "give me the rundown on NVDA" / "everything you know about $TICKER" — full cross-source profile of a US public company in ONE parallel call. ALWAYS PREFER over chaining single-pack SE

"What's new with X" / "latest on Y" / "what happened to Z this week / month / quarter" / "updates on Acme" / "news on Tesla recently" / "what's happening with Apple" — change feed for a company in the last N days/weeks/months in ONE parallel call. Fans out to SEC EDGAR (filings since `since`), GDELT

"Is it true that…" / "fact check" / "verify the claim that…" / "did X really…" / "was Y actually…" / "confirm or refute" / "true or false" — natural-language claim verification against authoritative sources. Use whenever the agent needs to check whether something a user said is factually correct. Co

Composite "should I add this npm package to my project" check in ONE call — fans out across deps.dev (license + advisories + version history) and bundlephobia (gzipped/minified bundle size, dependency count, ESM/tree-shake support). Use whenever an agent asks "is X safe / popular / small" or "what d

Research a Polymarket bet by pulling the relevant Pipeworx data for it in one call. Pass a market slug ("will-bitcoin-hit-150k-by-june-30-2026"), a polymarket.com URL, or a question text. The tool resolves the market, classifies the bet, fans out to category-specific data packs in parallel, and retu

Find arbitrage opportunities on Polymarket via monotonicity violations + partition-sum checks. Call with NO args for a `trending_scan` of the top ~200 markets by weekly volume; pass `event` for the strongest per-event partition_check, or `topic` for a themed cross-event scan. `event` (recommended fo

Scan top Polymarket markets and return opportunities where Pipeworx data disagrees with market price. Built for "what should I bet on today" — agents discover opportunities without paging hundreds of markets. FIVE MODEL FAMILIES grouped into three response segments under by_segment: (1) MODEL_DRIVEN

Cross-venue spread between Kalshi and Polymarket for the same resolving question. The two venues sometimes price the same outcome 2-25pp apart because their participant pools differ — when the bet shapes are equivalent that delta is a real signal, when they aren't the tool says so. TWO MODES: (1) `t

Realizable-vs-theoretical edge check against live CLOB order-book depth. REQUIRES one of `market` (single-market mode) or `event` (basket/partition mode). SINGLE-MARKET: pass a market slug/URL + side (buy_yes|sell_yes|buy_no|sell_no, default buy_yes) + size_usd (default 1000 — max spend on buys, tar

Edge persistence and decay telemetry built from daily polymarket_edges snapshots. Answers "how long has this edge existed and is it shrinking?" — a fresh wide edge and a 3-week-old wide edge are different trades (the latter is wide for a reason nobody is willing to take). Args: days (lookback, defau

What other AI agents are calling on Pipeworx right now. Returns the top tools, top packs, and total call volume over a recent window (24h, 7d, or 30d). Useful for: (1) discovering what data sources are hot for current events, (2) confirming a popular tool is the canonical choice before asking your o

What can I ask Pipeworx? / what is Pipeworx good for? / what can you do? / give me ideas / show me examples / getting started / what data do you have? — the onboarding entry point for an agent that just connected and wants to know what is worth asking. Returns category-bucketed example questions (co

Generate a production-ready llms.txt file for any URL so AI crawlers (ChatGPT, Claude, Perplexity) can index the site cleanly. Fetches the page, extracts title/description/key links, and emits the standard llms.txt markdown format. Output is a single text blob ready to drop at site-root/llms.txt. Us

Probe one or more LLMs for what they know about a business / brand / product / topic and score visibility (0-100) per model. Default model is Workers AI Llama-3.3-70b (free); pass `_apiKey` to also probe Anthropic (BYO key — you pay Anthropic directly for those calls). Returns per-model {score, conf

Compare AI visibility across multiple entities side-by-side. Probes each entity (your brand + N competitors) with ai_visibility_check, ranks by score, surfaces which is most/least recognized. Useful for competitive AI-marketing audits: "does Claude know about us as well as our competitors?". Returns

Tell the Pipeworx team something is broken, missing, or needs to exist. Use when a tool returns wrong/stale data (bug), when a tool you wish existed isn't in the catalog (feature/data_gap), or when something worked surprisingly well (praise). ONLY for tools served by this Pipeworx connection — if th

Save data the agent will need to reuse later — across this conversation or across sessions. Use when you discover something worth carrying forward (a resolved ticker, a target address, a user preference, a research subject) so you don't have to look it up again. Stored as a key-value pair scoped by

Retrieve a value previously saved via remember, or list all saved keys (omit the key argument). Use to look up context the agent stored earlier — the user's target ticker, an address, prior research notes — without re-deriving it from scratch. Scoped to your identifier (anonymous IP, BYO key hash, o

Delete a previously stored memory by key. Use when context is stale, the task is done, or you want to clear sensitive data the agent saved earlier. Pair with remember and recall.

ANSWERS "does Medicare cover X" / "is X covered by Medicare" / "what is Medicare's coverage policy for X" — searches current Medicare National Coverage Determinations (NCDs), the national policy documents that say whether Medicare covers a drug, device, procedure or therapy. Search by everyday produ

Retrieve one official Medicare National Coverage Determination by CMS document ID and optional version, including covered indications, limitations, effective dates, benefit category, and revision text.

Search current final Medicare Local Coverage Determinations (LCDs), optionally restricted to a state. LCDs are contractor- and jurisdiction-specific and can differ across locations.

Retrieve one Medicare LCD by document ID and version. Detailed LCD text requires a CMS license-agreement bearer token because documents may contain licensed AMA/ADA/AHA material; pass _licenseToken obtained directly from CMS after accepting those terms.

Search National Coverage Analyses (NCAs) and Coverage Analyses for Labs (CALs), including open and completed CMS evidence reviews. An open analysis is a policy process, not a coverage decision.

Retrieve one CMS National Coverage Analysis by document ID, including request, issue, benefit category, dates, decision memo, and public-comment status when supplied by CMS.

Recently published or updated national Medicare coverage documents from CMS, including NCDs, NCAs, CALs, MEDCAC meetings, and technology assessments.

List CMS Coverage API state identifiers used to scope local Medicare coverage searches.

Retrieve one CMS Medicare Coverage Article with its CPT/HCPCS codes and contractor records. Licensed AMA/ADA/AHA content requires a caller-provided CMS license token. Code inclusion describes billing guidance, not guaranteed coverage or payment.

Compare final LCD search matches across 1–15 states and Medicare Administrative Contractors. Different matching document counts or titles are policy signals, not proof of unequal beneficiary access or payment.

Retrieve official CMS version or revision history for a Medicare NCD, NCA, CAL, or LCD. Accepts either identifier CMS publishes for a coverage document: the public one that appears in the policy text and in every citation of it — an NCD section number such as 310.1 or 90.2, an NCA/CAL tracking numbe

Show annual Medicare Physician & Other Practitioners national utilization and payment metrics for one HCPCS code. Claims are fee-for-service aggregates with suppression and methodology limits; they do not measure total US use, coverage, demand, or company revenue.

Compare state-level Medicare fee-for-service provider, beneficiary, service, and average-payment metrics for one HCPCS code and program year. State beneficiary counts across places of service must not be summed as unique people.

Return a bounded sample of provider-level Medicare fee-for-service rows for one HCPCS code, optionally filtered by state, with the authoritative matching-row count. This is not a provider ranking and excludes suppressed/non-FFS activity.

UTILIZATION ANALYTICS for a product whose HCPCS billing codes you ALREADY KNOW: requires 1-5 caller-supplied HCPCS codes and combines their annual Medicare fee-for-service claim volumes and payments with matching coverage-policy documents. Use when you have the codes and want spend, volume and trend

Rank Medicare Part D drugs by total gross spending for a year — the biggest drugs in the Part D program, highest first. Answers "which drugs have the highest Medicare Part D spending", "top Part D drugs by cost", "what does Medicare spend the most on". Returns brand name, generic name and total spen

Search CMS Medicare Part D spending by brand or generic name and return 2020–2024 spending, claims, beneficiaries, dosage units, and unit-cost trends. Gross Part D spending is not manufacturer revenue, net price, profit, prescriptions, or total US sales.

Return a bounded sample of Medicare Part D prescriber-by-drug rows for an exact brand name in one year, optionally filtered by state, with the authoritative matching-row count. This is not a prescriber ranking and suppressed/non-Part-D activity is absent.

Profile Medicare Part D brand rows sharing an exact generic name, including CMS’s reported manufacturer count and 2020–2024 spending/use trends. Manufacturer count is a CMS aggregate, not a list of companies, products on market, or market share.

Return a bounded sample of hospital-level Medicare fee-for-service inpatient rows for an exact MS-DRG and year, optionally filtered by state, with the authoritative matching-row count. Average payments are not hospital revenue or margin.

Return a bounded sample of hospital-level Medicare fee-for-service outpatient rows for an exact APC and year, optionally filtered by state, with the authoritative matching-row count. APC payments are claims aggregates, not hospital revenue or margin.

Show annual national Medicare fee-for-service utilization and average-payment trends for one inpatient MS-DRG or outpatient APC using CMS geography/service aggregates. Trends exclude Medicare Advantage and do not measure total market demand, revenue, or profitability.

Return a bounded API-order sample of Medicare fee-for-service DME supplier rows for an exact HCPCS code and year, optionally filtered by state, with the authoritative matching-row count. This is not a supplier ranking or total market size.

Show annual national Medicare fee-for-service DME supplier, beneficiary, claim, service, and average-payment metrics for one HCPCS code. It excludes Medicare Advantage and is not total market demand or company revenue.

Return a bounded API-order sample of Medicare post-acute provider rows for home health, hospice, or skilled nursing in one year and optional state, with the authoritative matching-row count. Payments are not provider revenue or margin.

Show annual national Medicare fee-for-service beneficiaries, stays, service days, and payments for home health, hospice, or skilled nursing. Program definitions and year basis differ by service and the figures are not provider revenue.

Show annual Medicare enrollment and Medicare Advantage/other, Original Medicare, Part D PDP, Part D MA-PD, and dual-eligible counts nationally or for one state. Enrollment counts are program participation, not utilization or revenue.