Optum

Optum HCC Information API

The HCC Information API from Optum — 4 operation(s) for hcc information.

Documentation GitHub OpenAPI

Operations 4

GET /hcctype/{hccType}/{hccCode} Returns all the Diagnosis Codes for the supplied HCC Code #

GET /codetype/{codetype}/{code}/hcc Returns the HCC Data for I9V1/I10CM Code #

GET /hcctype/{hccType} Returns all the HCC Codes for the supplied HCC Type #

GET /hcctype Show HyperLinks to valid HCC types #

Work with this as data

Every API here is available over the APIs.io API and to AI agents over MCP.

MCP server

One button, every client — Claude, Cursor, VS Code and the rest.

https://apis.io/mcp

Tools for apis

7 MCP tools reach this

find_apisBrowse and filter every API in the catalog.
get_api_artifactsOne API's artifacts, grouped by type.
get_openapiThe primary OpenAPI for this API.
find_similar_apisAPIs that look like this one.
apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
resolveTurn a domain, URL or GitHub org into the provider it belongs to.
find_cohortsEvery scored population of providers in the catalog.

All 92 tools →

Call it yourself

curl for this page

This API

curl "https://apis.io/api/v1/apis/optum-hcc-information-api"

All apis

curl "https://apis.io/api/v1/apis?limit=25"

Discovery needs no key. Ratings and market analysis are Pro.

Get an API key

Free tier, no email required.

GitHub Google LinkedIn

A second provider on the same verified email joins the account you already have.

OpenAPI Specification

openapi: 3.2.0
info:
  title: Optum Real-Time eContent Web services HCC Information API
  description: Optum® Real-Time eContent web services provides access to both ondemand medical coding data and Optum coding tool logic required by your applications. The information you or your clients need is delivered to your application in real time, when you need it, and customized to how you want it displayed. Optum Real-Time eContent service provides access to the content of 37 printed coding resources and proprietary data and offers the power of the Optum CodeLogic™ search engine.
  contact:
    name: Ken Kracker
    email: ken.kracker@optum.com
  version: 1.0.0
servers:
- url: sandbox-apigw.optum.com/ci/rtec/v1/ws
security:
- bearerAuth: []
tags:
- name: HCC Information
paths:
  /hcctype/{hccType}/{hccCode}:
    get:
      tags:
      - HCC Information
      summary: Returns all the Diagnosis Codes for the supplied HCC Code
      operationId: getDiagList
      parameters:
      - name: hccType
        in: path
        description: Value for hccType
        required: true
        schema:
          type: string
          enum:
          - cms-hcc
          - cms-hcc-esrd-pace
          - rx-hcc
      - name: hccCode
        in: path
        description: Value for hccCode
        required: true
        schema:
          type: string
        example: HCC1
      - name: modelCategory
        in: query
        description: <b>cms-hcc</b><ul><li>v22 or v12</li></ul><b>cms-hcc-esrd-pace</b><br/><ul><li>none</li></ul><b>rx-hcc</b><br/><ul><li>v04 or none</li></ul>
        schema:
          type: string
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DiagnosisCodeList'
              example:
                cmsHccV22:
                - code: '042'
                  desc: Human immunodeficiency virus [HIV]
                - code: '079.53'
                  desc: Human immunodeficiency virus, type 2 (HIV 2), in conditions classified elsewhere and of unspecified site
                cmsHccV12:
                - code: '042'
                  desc: Human immunodeficiency virus [HIV]
                - code: '079.53'
                  desc: Human immunodeficiency virus, type 2 (HIV 2), in conditions classified elsewhere and of unspecified site
                - code: V08
                  desc: Asymptomatic human immunodeficiency virus (HIV) infection status
                cmsHccEsrdPace: []
                rxHccV04: []
                rxHcc: []
        '400':
          description: The provided code is not a valid HCC code
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DiagnosisCodeList'
              example:
                error:
                - Not a valid HCC Code for the cms-hcc type
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: No Drg code description found
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DiagnosisCodeList'
              example:
                error: []
                warning: []
                info:
                - No Drg code description found for the given Drg code you entered.
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /codetype/{codetype}/{code}/hcc:
    get:
      tags:
      - HCC Information
      summary: Returns the HCC Data for I9V1/I10CM Code
      operationId: getI9I10HccData
      parameters:
      - name: codetype
        in: path
        description: The codetype needed to identify the type of code
        required: true
        schema:
          type: string
          enum:
          - icd9v1
          - icd10cm
      - name: code
        in: path
        description: The value of the code
        required: true
        schema:
          type: string
        example: '042'
      - name: yyyy-mm-dd
        in: header
        description: Date needed for HCC Web Services
        schema:
          type: string
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                cmsHccV22:
                - hccCode: HCC1
                  desc: HIV/AIDS
                cmsHccV12:
                - hccCode: HCC1
                  desc: HIV/AIDS
                cmsHccEsrdPace:
                - hccCode: HCC1
                  desc: HIV/AIDS
                rxHccV04: []
                rxHcc:
                - hccCode: RXHCC1
                  desc: HIV/AIDS
        '400':
          description: The provided code is not a valid icd9v1/icd10cm code
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                error:
                - The provided code is not a valid icd9v1/icd10cm code
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: HCC Data does not exist for the particular icd9v1/icd10cm code
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                error:
                - HCC Data does not exist for the particular icd9v1/icd10cm code
                warning: []
                info: []
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /hcctype/{hccType}:
    get:
      tags:
      - HCC Information
      summary: Returns all the HCC Codes for the supplied HCC Type
      operationId: getHccData
      parameters:
      - name: hccType
        in: path
        description: Value for hccType
        required: true
        schema:
          type: string
          enum:
          - cms-hcc
          - cms-hcc-esrd-pace
          - rx-hcc
      - name: modelCategory
        in: query
        description: <b>cms-hcc</b><ul><li>v22 or v12</li></ul><b>cms-hcc-esrd-pace</b><br/><ul><li>none</li></ul><b>rx-hcc</b><br/><ul><li>v04 or none</li></ul>
        schema:
          type: string
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                cmsHccV22:
                - hccCode: HCC1
                  desc: HIV/AIDS
                  href: /ws/hcctype/cms-hcc/HCC1
                cmsHccV12:
                - hccCode: HCC1
                  desc: HIV/AIDS
                  href: /ws/hcctype/cms-hcc/HCC1
                cmsHccEsrdPace: []
                rxHccV04: []
                rxHcc: []
        '400':
          description: Not a valid HCC Code for the cms-hcc type
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                error:
                - Not a valid HCC Code for the cms-hcc type
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: No Diagnosis Code found for the HCC Code entered
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Hcc'
              example:
                error: []
                warning: []
                info:
                - No Diagnosis Code found for the HCC Code entered.
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /hcctype:
    get:
      tags:
      - HCC Information
      summary: Show HyperLinks to valid HCC types
      operationId: getHCCTypes
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                type: array
                items:
                  $ref: '#/components/schemas/Link'
              example:
              - href: /ws/hcctype/cms-hcc
                value: cms-hcc
              - href: /ws/hcctype/cms-hcc-esrd-pace
                value: cms-hcc-esrd-pace
              - href: /ws/hcctype/rx-hcc
                value: rx-hcc
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: Not Found - the data was not found
          content:
            application/json:
              example:
                error:
                - The requested resource does not exist.
                warning: []
                info: []
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
components:
  schemas:
    Link:
      type: object
      properties:
        href:
          type: string
          xml:
            attribute: true
        value:
          type: string
    RxHcc:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
    CmsHccEsrdPace:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
    CmsHccVx:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
    Hcc:
      required:
      - cmsHccEsrdPace
      - cmsHccV12
      - cmsHccV22
      - rxHcc
      - rxHccV04
      type: object
      properties:
        cmsHccV22:
          type: array
          xml:
            name: cms-hcc-v22
          items:
            $ref: '#/components/schemas/CmsHccV22'
        cmsHccVx:
          type: array
          xml:
            name: cms-hcc-vx
          items:
            $ref: '#/components/schemas/CmsHccVx'
        cmsHccV12:
          type: array
          xml:
            name: cms-hcc-v12
          items:
            $ref: '#/components/schemas/CmsHccV12'
        cmsHccEsrdPace:
          type: array
          xml:
            name: cms-hcc-esrd-pace
          items:
            $ref: '#/components/schemas/CmsHccEsrdPace'
        rxHccV04:
          type: array
          xml:
            name: rx-hcc-v04
          items:
            $ref: '#/components/schemas/RxHccV04'
        rxHcc:
          type: array
          xml:
            name: rx-hcc
          items:
            $ref: '#/components/schemas/RxHcc'
      xml:
        name: hcc
    RxHccV04:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
    CmsHccV12:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
    DiagnosisCodeList:
      required:
      - cmsHccEsrdPace
      - cmsHccV12
      - cmsHccV22
      - cmsHccVx
      - rxHcc
      - rxHccV04
      type: object
      properties:
        cmsHccV22:
          type: array
          xml:
            name: cms-hcc-v22
          items:
            $ref: '#/components/schemas/CmsHccV22'
        cmsHccVx:
          type: array
          xml:
            name: cms-hcc-vx
          items:
            $ref: '#/components/schemas/CmsHccVx'
        cmsHccV12:
          type: array
          xml:
            name: cms-hcc-v12
          items:
            $ref: '#/components/schemas/CmsHccV12'
        cmsHccEsrdPace:
          type: array
          xml:
            name: cms-hcc-esrd-pace
          items:
            $ref: '#/components/schemas/CmsHccEsrdPace'
        rxHccV04:
          type: array
          xml:
            name: rx-hcc-v04
          items:
            $ref: '#/components/schemas/RxHccV04'
        rxHcc:
          type: array
          xml:
            name: rx-hcc
          items:
            $ref: '#/components/schemas/RxHcc'
      xml:
        name: diagnosis-code-list
    CmsHccV22:
      type: object
      properties:
        hccCode:
          type: string
          xml:
            name: hcc-code
        desc:
          type: string
        href:
          type: string
          xml:
            attribute: true
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
    ws_auth:
      type: oauth2
      flows:
        authorizationCode:
          authorizationUrl: https://idx.linkhealth.com/auth
          tokenUrl: https://idx.linkhealth.com/auth/token
          scopes:
            scope-1: required scope for API access
x-readme:
  explorer-enabled: true
  proxy-enabled: true