CMS — Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) is the U.S. federal agency within the Department of Health and Human Services that administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Health Insurance Marketplace, and the broader CMS open-data program. CMS operates one of the largest collections of HL7 FHIR APIs in the U.S. federal government — Blue Button 2.0, BCDA, AB2D, DPC, and the upstream BFD server — alongside the Marketplace API, the data.cms.gov open-data catalog, the Provider Data Catalog, the Quality Payment Program API, and the Medicare Coverage Database.

10 APIs 0 Features

HealthcareMedicareMedicaidFHIRBulk DataOpen DataGovernmentFederalClaimsInsuranceACAMarketplaceQuality

APIs

CMS Blue Button 2.0 API

Blue Button 2.0 is a developer-friendly, OAuth 2.0-enabled, HL7 FHIR R4 standard data API that delivers Medicare Part A, B, and D claims data for 60+ million Medicare beneficiar...

CMS Beneficiary Claims Data API (BCDA)

BCDA enables Medicare Shared Savings Program Accountable Care Organizations (ACOs) to retrieve bulk Medicare Parts A, B, and D claims data for their assigned and assignable bene...

CMS AB2D API

AB2D (Claim and Claim Line Feed) delivers Medicare Parts A, B, and D claims data to Part D prescription drug plan sponsors via the HL7 FHIR Bulk Data Access specification. Suppo...

CMS Data at the Point of Care API (DPC)

Data at the Point of Care fills gaps in patient history by delivering Medicare claims data via HL7 FHIR Bulk Data Access to fee-for-service providers at the point of care. Provi...

CMS Beneficiary FHIR Data Server (BFD)

The Beneficiary FHIR Data (BFD) Server is the upstream HL7 FHIR R4 service that powers Blue Button 2.0, BCDA, AB2D, and DPC. BFD ingests claims from the CMS Chronic Conditions W...

CMS Marketplace API

The Marketplace API exposes Qualified Health Plan (QHP) and Stand-alone Dental Plan (SADP) data from healthcare.gov including plan finder, plan compare, plan rates, plan benefit...

CMS Open Data API (data.cms.gov)

The CMS Open Data API exposes the full catalog of public CMS datasets — Medicare provider utilization and payment files, Medicare Advantage and Part D enrollment, Hospital Compa...

CMS Provider Data Catalog API

The Provider Data Catalog API surfaces the quality and compare datasets that powered the legacy Hospital Compare, Nursing Home Compare, Home Health Compare, Hospice Compare, Lon...

CMS Quality Payment Program API

The Quality Payment Program (QPP) API supports the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) under MACRA. Exposes measures, benc...

CMS Medicare Coverage Database API

The Medicare Coverage Database (MCD) exposes National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), Local Coverage Articles, Proposed Decisions, National...

Collections

CMS AB2D API

OPEN

CMS Beneficiary Claims Data API (BCDA)

OPEN

CMS Beneficiary FHIR Data Server (BFD)

OPEN

CMS Blue Button 2.0 API

OPEN

CMS Data at the Point of Care API (DPC)

OPEN

CMS Marketplace API

OPEN

CMS Medicare Coverage Database API

OPEN

CMS Open Data API (data.cms.gov)

OPEN

CMS Provider Data Catalog API

OPEN

CMS Quality Payment Program API

OPEN

Rate Limits

Cms Gov Rate Limits

0 limits

RATE LIMITS

Semantic Vocabularies

Cms Gov Context

0 classes · 6 properties

JSON-LD

API Governance Rules

CMS — Centers for Medicare & Medicaid Services API Rules

7 rules · 1 errors 4 warnings

SPECTRAL

Example Payloads

Cms Gov Bcda Job Example

5 fields

EXAMPLE

Cms Gov Explanation Of Benefit Example

16 fields

EXAMPLE

Cms Gov Marketplace Plan Example

14 fields

EXAMPLE

Cms Gov Patient Example

8 fields

EXAMPLE

Resources

Authentication

Authentication

Documentation

Documentation

Documentation

Documentation

Sources

opencollection: 1.0.0
info:
  name: CMS Quality Payment Program API
  version: '1.0'
request:
  auth:
    type: bearer
    token: '{{bearerToken}}'
items:
- info:
    name: Submissions
    type: folder
  items:
  - info:
      name: List Submissions
      type: http
    http:
      method: GET
      url: https://qpp.cms.gov/api/submissions
    docs: List Submissions
  - info:
      name: Create Submission
      type: http
    http:
      method: POST
      url: https://qpp.cms.gov/api/submissions
      body:
        type: json
        data: '{}'
    docs: Create Submission
  - info:
      name: Get Submission
      type: http
    http:
      method: GET
      url: https://qpp.cms.gov/api/submissions/:id
      params:
      - name: id
        value: ''
        type: path
    docs: Get Submission
  - info:
      name: Update Submission
      type: http
    http:
      method: PUT
      url: https://qpp.cms.gov/api/submissions/:id
      params:
      - name: id
        value: ''
        type: path
      body:
        type: json
        data: '{}'
    docs: Update Submission
- info:
    name: Measurements
    type: folder
  items:
  - info:
      name: List Measurements
      type: http
    http:
      method: GET
      url: https://qpp.cms.gov/api/measurements
    docs: List Measurements
  - info:
      name: Create Measurement
      type: http
    http:
      method: POST
      url: https://qpp.cms.gov/api/measurements
      body:
        type: json
        data: '{}'
    docs: Create Measurement
- info:
    name: Scoring
    type: folder
  items:
  - info:
      name: Get Score Preview
      type: http
    http:
      method: GET
      url: https://qpp.cms.gov/api/scoring
      params:
      - name: submissionId
        value: ''
        type: query
    docs: Get Score Preview
- info:
    name: Benchmarks
    type: folder
  items:
  - info:
      name: List Benchmarks
      type: http
    http:
      method: GET
      url: https://qpp.cms.gov/api/benchmarks
      params:
      - name: performanceYear
        value: ''
        type: query
    docs: List Benchmarks
bundled: true