Centers for Medicare and Medicaid Services

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
accessModel:
  pricing: freemium
  onboarding: self-serve
  trial: false
  try_now: true
  public: false
  label: Freemium · Self-serve signup
  confidence: high
  source:
  - plans
  - authentication
  generated: '2026-07-22'
  method: derived
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/centers-for-medicare-and-medicaid-services.png
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-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.
- aid: centers-for-medicare-and-medicaid-services:centers-for-medicare-and-medicaid-services-capability-api
  name: Centers for Medicare and Medicaid Services Capability API
  description: FHIR server capability statements and metadata.
  humanURL: https://bluebutton.cms.gov/
  baseURL: https://api.bluebutton.cms.gov/v2/fhir/
  tags:
  - Capability
  properties:
  - type: OpenAPI
    url: openapi/centers-for-medicare-and-medicaid-services-capability-api-openapi.yml
  - type: Website
    url: https://bluebutton.cms.gov/
  - type: Developer
    url: https://bluebutton.cms.gov/developers/
  - type: Documentation
    url: https://bluebutton.cms.gov/api-documentation/
  - type: Sandbox
    url: https://sandbox.bluebutton.cms.gov/
  - type: Resources
    url: https://bluebutton.cms.gov/resources/
- aid: centers-for-medicare-and-medicaid-services:centers-for-medicare-and-medicaid-services-coverage-api
  name: Centers for Medicare and Medicaid Services Coverage API
  description: Beneficiary coverage records.
  humanURL: https://bluebutton.cms.gov/
  baseURL: https://api.bluebutton.cms.gov/v2/fhir/
  tags:
  - Coverage
  properties:
  - type: OpenAPI
    url: openapi/centers-for-medicare-and-medicaid-services-coverage-api-openapi.yml
  - type: Website
    url: https://bluebutton.cms.gov/
  - type: Developer
    url: https://bluebutton.cms.gov/developers/
  - type: Documentation
    url: https://bluebutton.cms.gov/api-documentation/
  - type: Sandbox
    url: https://sandbox.bluebutton.cms.gov/
  - type: Resources
    url: https://bluebutton.cms.gov/resources/
- aid: centers-for-medicare-and-medicaid-services:centers-for-medicare-and-medicaid-services-explanationofbenefit-api
  name: Centers for Medicare and Medicaid Services ExplanationOfBenefit API
  description: Medicare claims expressed as ExplanationOfBenefit resources.
  humanURL: https://bluebutton.cms.gov/
  baseURL: https://api.bluebutton.cms.gov/v2/fhir/
  tags:
  - ExplanationOfBenefit
  properties:
  - type: OpenAPI
    url: openapi/centers-for-medicare-and-medicaid-services-explanationofbenefit-api-openapi.yml
  - type: Website
    url: https://bluebutton.cms.gov/
  - type: Developer
    url: https://bluebutton.cms.gov/developers/
  - type: Documentation
    url: https://bluebutton.cms.gov/api-documentation/
  - type: Sandbox
    url: https://sandbox.bluebutton.cms.gov/
  - type: Resources
    url: https://bluebutton.cms.gov/resources/
- aid: centers-for-medicare-and-medicaid-services:centers-for-medicare-and-medicaid-services-patient-api
  name: Centers for Medicare and Medicaid Services Patient API
  description: Beneficiary (Patient) resources.
  humanURL: https://bluebutton.cms.gov/
  baseURL: https://api.bluebutton.cms.gov/v2/fhir/
  tags:
  - Patient
  properties:
  - type: OpenAPI
    url: openapi/centers-for-medicare-and-medicaid-services-patient-api-openapi.yml
  - type: Website
    url: https://bluebutton.cms.gov/
  - type: Developer
    url: https://bluebutton.cms.gov/developers/
  - type: Documentation
    url: https://bluebutton.cms.gov/api-documentation/
  - type: Sandbox
    url: https://sandbox.bluebutton.cms.gov/
  - type: Resources
    url: https://bluebutton.cms.gov/resources/
common:
- type: AgenticAccess
  url: agentic-access/centers-for-medicare-and-medicaid-services-agentic-access.yml
- type: DomainSecurity
  url: security/centers-for-medicare-and-medicaid-services-domain-security.yml
- type: Authentication
  url: authentication/centers-for-medicare-and-medicaid-services-authentication.yml
- type: OAuthScopes
  url: scopes/centers-for-medicare-and-medicaid-services-scopes.yml
- 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