Optum
Optum, part of UnitedHealth Group, is a health services and technology company that operates one of the largest medical, dental and pharmacy networks in the United States and runs the clearinghouse formerly known as Change Healthcare. Its developer platform (developer.optum.com) publishes eight product lines of RESTful JSON, native X12 EDI and HL7 FHIR R4 APIs: eligibility and coverage discovery, professional and institutional claim validation and submission, claim status, ERA/remittance reports, attachments, payer directory and outage feeds, prior authorization in both X12 278 and FHIR Da Vinci PAS/DTR/CRD form, provider access and bulk member match, dental pre-care estimates and claims, pharmacy formatting and submitter services, payer enrollment and document tracking, and Optum Insight Platform data, code-search and analytics services. Every API is secured with an OAuth2 client-credentials JWT bearer token over TLS 1.2+, with a free canned-response sandbox on a separate host. Optum also publishes an RFC 9727 API catalog at /.well-known/api-catalog, which is how the 59 OpenAPI documents in this repo were harvested.
Optum publishes 165 APIs on the APIs.io network, including Real (Medical) API, Ambulance Fee Schedule APIs API, Anesthesia Fee APIs API, and 162 more. Tagged areas include Company, Healthcare, Health Insurance, Claims, and Eligibility.
The Optum catalog on APIs.io includes 1 event-driven AsyncAPI specification.
Optum’s developer surface includes authentication, documentation, API reference, getting-started guide, support, signup flow, sandbox, and 33 more developer resources.
What this lets a business do 5
Business capabilities this provider's published APIs can perform, derived from its own contracts. Browse all capabilities →
Kin Score
APIs 166
Individual APIs this provider publishes, each with its own machine-readable definition.
Optum Real (Medical) API
Optum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions, claim inquiry, patient benefit check, document search, auth referral...
Optum Interoperability APIs (CMS Patient Access)
Optum's payer-side CMS Interoperability and Patient Access (CMS-9115-F) surface — Patient Access, Provider Directory and Payer-to-Payer exchange for the Optum behavioral and phy...
Optum Ambulance Fee Schedule APIs API
The Ambulance Fee Schedule APIs API from Optum — 2 operation(s) for ambulance fee schedule apis.
Optum Anesthesia Fee APIs API
The Anesthesia Fee APIs API from Optum — 1 operation(s) for anesthesia fee apis.
Optum APC Calculator APIs API
The APC Calculator APIs API from Optum — 1 operation(s) for apc calculator apis.
Optum APC Cross Codes APIs API
The APC Cross Codes APIs API from Optum — 3 operation(s) for apc cross codes apis.
Optum Apip API
The Apip API from Optum — 2 operation(s) for apip.
Optum Application.wadl API
The Application.wadl API from Optum — 2 operation(s) for application.wadl.
Optum Attachment API
The Attachment API from Optum — 11 operation(s) for attachment.
Optum Attachment Document API
The Attachment Document API from Optum — 2 operation(s) for attachment document.
Optum Attachment Status API
The Attachment Status API from Optum — 2 operation(s) for attachment status.
Optum Attachment Submission API
Attachment Submission
Optum Authentication API
The Authentication API from Optum — 1 operation(s) for authentication.
Optum Authorization (Orchestration) API
The Authorization (Orchestration) API from Optum — 2 operation(s) for authorization (orchestration).
Optum Average Sales Price APIs API
The Average Sales Price APIs API from Optum — 1 operation(s) for average sales price apis.
Optum CC/MCC Code and Excludes List for I10CM and I9V1 APIs API
The CC/MCC Code and Excludes List for I10CM and I9V1 APIs API from Optum — 2 operation(s) for cc/mcc code and excludes list for i10cm and i9v1 apis.
Optum CCI Edits APIs API
The CCI Edits APIs API from Optum — 10 operation(s) for cci edits apis.
Optum CCI Edits Code Validator API
The CCI Edits Code Validator API API from Optum — 1 operation(s) for cci edits code validator api.
Optum CDI and Coding Support PDF Information API
The CDI and Coding Support PDF Information API from Optum — 1 operation(s) for cdi and coding support pdf information.
Optum CDI Information API
The CDI Information API from Optum — 2 operation(s) for cdi information.
Optum Check Enhanced Dental Eligibility API
The Check Enhanced Dental Eligibility API from Optum — 1 operation(s) for check enhanced dental eligibility.
Optum Claim Adjustment Reasons Codes APIs API
The Claim Adjustment Reasons Codes APIs API from Optum — 1 operation(s) for claim adjustment reasons codes apis.
Optum Claim API
The Claim API from Optum — 2 operation(s) for claim.
Optum Claim Review API
The Claim Review API from Optum — 1 operation(s) for claim review.
Optum Claim Status API
Claim Status API
Optum Claim Status API
The Claim Status API from Optum — 1 operation(s) for claim status.
Optum Claim Status Category Code APIs API
The Claim Status Category Code APIs API from Optum — 1 operation(s) for claim status category code apis.
Optum Claim Status Code APIs API
The Claim Status Code APIs API from Optum — 1 operation(s) for claim status code apis.
Optum Claim Pre Check API
The ClaimPreCheck API from Optum — 1 operation(s) for claimprecheck.
Optum Clinical Diagnostic Laboratory APIs API
The Clinical Diagnostic Laboratory APIs API from Optum — 1 operation(s) for clinical diagnostic laboratory apis.
Optum CMS HCC APIs API
The CMS HCC APIs API from Optum — 3 operation(s) for cms hcc apis.
Optum CMS IOM's Policy APIs API
The CMS IOM's Policy APIs API from Optum — 1 operation(s) for cms iom's policy apis.
Optum CMS Transmittal APIs API
The CMS Transmittal APIs API from Optum — 3 operation(s) for cms transmittal apis.
Optum Code Book APIs API
The Code Book APIs API from Optum — 2 operation(s) for code book apis.
Optum Code Fee API
The Code Fee API from Optum — 4 operation(s) for code fee.
Optum Code History APIs API
The Code History APIs API from Optum — 1 operation(s) for code history apis.
Optum Code Image APIs API
The Code Image APIs API from Optum — 3 operation(s) for code image apis.
Optum Code Information API
The Code Information API from Optum — 15 operation(s) for code information.
Optum Code Information APIs API
The Code Information APIs API from Optum — 9 operation(s) for code information apis.
Optum Code Specific Guidelines API
The Code Specific Guidelines API from Optum — 2 operation(s) for code specific guidelines.
Optum Code Specific Guidelines APIs API
The Code Specific Guidelines APIs API from Optum — 2 operation(s) for code specific guidelines apis.
Optum Coding Documentation Guideline APIs API
The Coding Documentation Guideline APIs API from Optum — 2 operation(s) for coding documentation guideline apis.
Optum Coding Support API
The Coding Support API from Optum — 1 operation(s) for coding support.
Optum Coding Tips API
The Coding Tips API API from Optum — 2 operation(s) for coding tips api.
Optum Color Codes API
The Color Codes API from Optum — 5 operation(s) for color codes.
Optum Color codes APIs API
The Color codes APIs API from Optum — 23 operation(s) for color codes apis.
Optum Compliance APIs API
The Compliance APIs API from Optum — 5 operation(s) for compliance apis.
Optum Consumer Code Manager API
The Consumer Code Manager API API from Optum — 1 operation(s) for consumer code manager api.
Optum Coverage Discovery API
Create and retrieve asynchronous Coverage Discovery tasks. Coverage Discovery paths and add-ons are enabled per customer and are not included automatically. These endpoints supp...
Optum Create Attachments API
Operations for creating and uploading attachments.
Optum Cross Coder API
The Cross Coder API API from Optum — 3 operation(s) for cross coder api.
Optum Data File API
The Data File API from Optum — 2 operation(s) for data file.
Optum Decision Support Record Service API
The DecisionSupportRecordService API from Optum — 2 operation(s) for decisionsupportrecordservice.
Optum Dental Claim Actions API
The Dental Claim Actions API from Optum — 1 operation(s) for dental claim actions.
Optum Determination API
The Determination API from Optum — 2 operation(s) for determination.
Optum Device Codes APIs API
The Device Codes APIs API from Optum — 3 operation(s) for device codes apis.
Optum Device Offset Codes Pair APIs API
The Device Offset Codes Pair APIs API from Optum — 1 operation(s) for device offset codes pair apis.
Optum Diagnostic Related Groups (DRG) Indicators APIs API
The Diagnostic Related Groups (DRG) Indicators APIs API from Optum — 1 operation(s) for diagnostic related groups (drg) indicators apis.
Optum Discovery API
The Discovery API from Optum — 1 operation(s) for discovery.
Optum DME and PEN Fee Schedule APIs API
The DME and PEN Fee Schedule APIs API from Optum — 3 operation(s) for dme and pen fee schedule apis.
Optum Document Reference API
The DocumentReference API from Optum — 1 operation(s) for documentreference.
Optum Document Retrieve API
The documentRetrieve API from Optum — 1 operation(s) for documentretrieve.
Optum Document Search API
The documentSearch API from Optum — 1 operation(s) for documentsearch.
Optum DRG Calculator APIs API
The DRG Calculator APIs API from Optum — 1 operation(s) for drg calculator apis.
Optum DRG Codes API
The DRG Codes API from Optum — 1 operation(s) for drg codes.
Optum DRG Information APIs API
The DRG Information APIs API from Optum — 6 operation(s) for drg information apis.
Optum Dtr Capability Statement API
The DtrCapabilityStatement API from Optum — 1 operation(s) for dtrcapabilitystatement.
Optum Eligibility API
Medical Eligibility
Optum Eligibility Requests API
Submit new real-time eligibility transactions. These endpoints accept either a normalized JSON request or a JSON request body with `x12` set to the X12 270 payload, and return a...
Optum Eligibility Transactions API
Retrieve previously processed real-time eligibility transactions. Use these endpoints to list transactions, filter by status, date range, patient details, or correlation metadat...
Optum ERA Enrollment API
ERA Enrollment API
Optum Exports API
The Exports API from Optum — 1 operation(s) for exports.
Optum Facility Compliance APIs API
The Facility Compliance APIs API from Optum — 12 operation(s) for facility compliance apis.
Optum Federal Register Addendum B API
The Federal Register Addendum B API API from Optum — 1 operation(s) for federal register addendum b api.
Optum Federal Register Addendum B History API
The Federal Register Addendum B History API API from Optum — 1 operation(s) for federal register addendum b history api.
Optum Fields API
The Fields API from Optum — 1 operation(s) for fields.
Optum Filter Dictionary Terms API
Filter dictionary terms from a given string
Optum Future Codes APIs API
The Future Codes APIs API from Optum — 1 operation(s) for future codes apis.
Optum Get Doc Counts API
The GetDocCounts API from Optum — 1 operation(s) for getdoccounts.
Optum Get Document Status API
The GetDocumentStatus API from Optum — 1 operation(s) for getdocumentstatus.
Optum Get File Status API
The GetFileStatus API from Optum — 1 operation(s) for getfilestatus.
Optum Get Listof Doc Status API
The GetListofDocStatus API from Optum — 1 operation(s) for getlistofdocstatus.
Optum Get List Of File Status API
The GetListOfFileStatus API from Optum — 1 operation(s) for getlistoffilestatus.
Optum HCC Information API
The HCC Information API from Optum — 4 operation(s) for hcc information.
Optum HCPCS Table of Drugs API
The HCPCS Table of Drugs API API from Optum — 1 operation(s) for hcpcs table of drugs api.
Optum Health Care Decision Reason API
The Health Care Decision Reason API API from Optum — 1 operation(s) for health care decision reason api.
Optum Health Check API
The Health Check API from Optum — 7 operation(s) for health check.
Optum Health Check API
The HealthCheck API from Optum — 14 operation(s) for healthcheck.
Optum I-OCE Edits APIs API
The I-OCE Edits APIs API from Optum — 4 operation(s) for i-oce edits apis.
Optum I10PCS Code Builder APIs API
The I10PCS Code Builder APIs API from Optum — 3 operation(s) for i10pcs code builder apis.
Optum ICD10 Mapping API
The ICD10 Mapping API from Optum — 1 operation(s) for icd10 mapping.
Optum ICD9 Mapping API
The ICD9 Mapping API from Optum — 1 operation(s) for icd9 mapping.
Optum Image Intelligence API
Operations for enabling Image Intelligence for attachments.
Optum Inquiry API
The Inquiry API from Optum — 3 operation(s) for inquiry.
Optum Institutional Claims API
Institutional Claims
Optum LCD API
The LCD API from Optum — 4 operation(s) for lcd.
Optum Mapping APIs API
The Mapping APIs API from Optum — 4 operation(s) for mapping apis.
Optum MCE Associated ICD10 APIs API
The MCE Associated ICD10 APIs API from Optum — 3 operation(s) for mce associated icd10 apis.
Optum MCE Associated ICD9 APIs API
The MCE Associated ICD9 APIs API from Optum — 1 operation(s) for mce associated icd9 apis.
Optum MCE Edits ICD9 and ICD10 API
The MCE Edits ICD9 and ICD10 API API from Optum — 3 operation(s) for mce edits icd9 and icd10 api.
Optum MDC Optimizing Tips APIs API
The MDC Optimizing Tips APIs API from Optum — 2 operation(s) for mdc optimizing tips apis.
Optum Medically Unlikely Edits(MUEs) APIs API
The Medically Unlikely Edits(MUEs) APIs API from Optum — 1 operation(s) for medically unlikely edits(mues) apis.
Optum Medicare Carrier Localities API
The Medicare Carrier Localities API from Optum — 1 operation(s) for medicare carrier localities.
Optum Medicare Coverage Policy for part A and Part B APIs API
The Medicare Coverage Policy for part A and Part B APIs API from Optum — 4 operation(s) for medicare coverage policy for part a and part b apis.
Optum Medicare Fee Schedule APIs API
The Medicare Fee Schedule APIs API from Optum — 10 operation(s) for medicare fee schedule apis.
Optum Medicare Policy API
The Medicare Policy API from Optum — 3 operation(s) for medicare policy.
Optum Merck Manual API
The Merck Manual API API from Optum — 2 operation(s) for merck manual api.
Optum Modifier CrossWalk API
The Modifier CrossWalk API API from Optum — 2 operation(s) for modifier crosswalk api.
Optum Modifiers API
The Modifiers API from Optum — 5 operation(s) for modifiers.
Optum Modifiers APIs API
The Modifiers APIs API from Optum — 6 operation(s) for modifiers apis.
Optum MPFS National Payment Table Facility APIs API
The MPFS National Payment Table Facility APIs API from Optum — 1 operation(s) for mpfs national payment table facility apis.
Optum National Charge Data API
The National Charge Data API API from Optum — 1 operation(s) for national charge data api.
Optum National Drug Code API
The National Drug Code API API from Optum — 1 operation(s) for national drug code api.
Optum Next Question API
The NextQuestion API from Optum — 1 operation(s) for nextquestion.
Optum Noa API
The Noa API from Optum — 2 operation(s) for noa.
Optum Not Otherwise Classified (NOC) Drug Pricing APIs API
The Not Otherwise Classified (NOC) Drug Pricing APIs API from Optum — 1 operation(s) for not otherwise classified (noc) drug pricing apis.
Optum Notes Information APIs API
The Notes Information APIs API from Optum — 6 operation(s) for notes information apis.
Optum Oihub API
The Oihub API from Optum — 1 operation(s) for oihub.
Optum Operation Definition API
The OperationDefinition API from Optum — 1 operation(s) for operationdefinition.
Optum Opps Cross Codes API
The Opps Cross Codes API API from Optum — 1 operation(s) for opps cross codes api.
Optum OPPS CrossCode Code API
The OPPS CrossCode Code API from Optum — 1 operation(s) for opps crosscode code.
Optum OPSI Codes APIs API
The OPSI Codes APIs API from Optum — 3 operation(s) for opsi codes apis.
Optum Optum Specialty Articles API
The Optum Specialty Articles API from Optum — 1 operation(s) for optum specialty articles.
Optum Order Management API
The Order Management API from Optum — 10 operation(s) for order management.
Optum Order Sign API
The OrderSign API from Optum — 1 operation(s) for ordersign.
Optum Outages API
The Outages API from Optum — 1 operation(s) for outages.
Optum Pas Capability Statement API
The PasCapabilityStatement API from Optum — 1 operation(s) for pascapabilitystatement.
Optum Payers API
The Payers API from Optum — 1 operation(s) for payers.
Optum Payersheet API
API to process Payersheet information
Optum Payments API
The Payments API from Optum — 2 operation(s) for payments.
Optum Policy Lookup APIs API
The Policy Lookup APIs API from Optum — 4 operation(s) for policy lookup apis.
Optum Prepaydme API
The prepaydme API from Optum — 1 operation(s) for prepaydme.
Optum Prepaylab API
The prepaylab API from Optum — 1 operation(s) for prepaylab.
Optum Print Code Detail Summary API
The Print Code Detail Summary API API from Optum — 1 operation(s) for print code detail summary api.
Optum prior auth API
The prior auth api API from Optum — 1 operation(s) for prior auth api.
Optum Professional Claims API
Professional Claims
Optum Prometheus API
The Prometheus API from Optum — 2 operation(s) for prometheus.
Optum Provider Lookup APIs API
The Provider Lookup APIs API from Optum — 1 operation(s) for provider lookup apis.
Optum Provider Participation List API
The Provider Participation List API from Optum — 1 operation(s) for provider participation list.
Optum Provider Access Bulk Member Match API
The ProviderAccessBulkMemberMatch API from Optum — 1 operation(s) for provideraccessbulkmembermatch.
Optum Provider Access Bulk Member Match Status API
The ProviderAccessBulkMemberMatchStatus API from Optum — 1 operation(s) for provideraccessbulkmembermatchstatus.
Optum Provider Access Da Vinci Export API
The ProviderAccessDaVinciExport API from Optum — 1 operation(s) for provideraccessdavinciexport.
Optum Provider Access Da Vinci Export Download API
The ProviderAccessDaVinciExportDownload API from Optum — 1 operation(s) for provideraccessdavinciexportdownload.
Optum QPP MIPS APIs API
The QPP MIPS APIs API from Optum — 4 operation(s) for qpp mips apis.
Optum Query Service API
The QueryService API from Optum — 1 operation(s) for queryservice.
Optum Questionnaire Package API
The QuestionnairePackage API from Optum — 1 operation(s) for questionnairepackage.
Optum Reference Code API
The Reference Code API from Optum — 6 operation(s) for reference code.
Optum Release Dates API
The Release Dates API API from Optum — 1 operation(s) for release dates api.
Optum Remittance Advice Remark Codes APIs API
The Remittance Advice Remark Codes APIs API from Optum — 1 operation(s) for remittance advice remark codes apis.
Optum Report API
The Report API from Optum — 3 operation(s) for report.
Optum Reports API
The Reports API from Optum — 1 operation(s) for reports.
Optum Revenue Code API
The Revenue Code API from Optum — 4 operation(s) for revenue code.
Optum Revenue Codes API
The Revenue Codes API API from Optum — 4 operation(s) for revenue codes api.
Optum Review Attachments API
Operations for retrieving attachments for review.
Optum Roster Management API
The Roster Management API from Optum — 1 operation(s) for roster management.
Optum State List Fee Schedule APIs API
The State List Fee Schedule APIs API from Optum — 1 operation(s) for state list fee schedule apis.
Optum Submission API
The Submission API from Optum — 2 operation(s) for submission.
Optum Submit API
The Submit API from Optum — 1 operation(s) for submit.
Optum Submit Attachment API
The SubmitAttachment API from Optum — 1 operation(s) for submitattachment.
Optum Submitter API Request HTTP Controller API
The submitter-api-request-http-controller API from Optum — 1 operation(s) for submitter-api-request-http-controller.
Optum Supporting Documentation APIs API
The Supporting Documentation APIs API from Optum — 2 operation(s) for supporting documentation apis.
Optum Telecom Format API
API to format details received in a request
Optum Type of Bill I/OCE Edit OPPS API
The Type of Bill I/OCE Edit OPPS API from Optum — 2 operation(s) for type of bill i/oce edit opps.
Optum UB04 Code Lists API
The UB04 Code Lists API from Optum — 1 operation(s) for ub04 code lists.
Optum V3 Ingestion API
ODX V3 Ingestion Service API for processing XDR Request in P&R request with HL7 V3 payload
Optum Wage Index API
The Wage Index API API from Optum — 1 operation(s) for wage index api.
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Pricing Plans 1
Published pricing tiers and plan structures.
Optum Plans Pricing
PLANSRate Limits 1
Documented rate limits and quota policies.
Optum Rate Limits
RATE LIMITSEvent Specifications 1
AsyncAPI definitions for this provider's event-driven and streaming APIs.
Optum Webhooks
ASYNCAPISecurity Posture 3
Authentication, domain security, vulnerability disclosure, and trust-center signals.
Scopes 1
OAuth scopes governing access to this provider's APIs.
Agentic Access 1
Recommended x-agentic-access execution contracts for AI agents.
Resources
Get Started 5
Portal, sign-up, and the first successful call
Documentation 2
Reference material describing how the API behaves
Agent Surfaces 4
MCP servers, agent skills, and machine-readable catalogs
Design & Contract 6
Pagination, idempotency, versioning, errors, and events
Build 3
SDKs, sample code, and the tooling you integrate with
Access & Security 7
Authentication, authorization, and security posture
Scroll for all 7
Operate 4
Status, limits, changes, and where to get help
Commercial 4
Pricing, plans, and the legal terms of use
Company 2
The organization behind the API
Other 3
Properties that don't map to a standard resource type
Source (apis.yml)
Work with this as data
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