Compare policies across jurisdictions
Compare coverage policies across MAC jurisdictions for the same procedure codes.
Endpoint: POST /api/v1/policies/compare
Availability: Live in production.
Authentication: API key in Authorization: Bearer <key> with the read scope.
Compare coverage policies across MAC jurisdictions for the same procedure codes. National policies are listed separately and also applied to every jurisdiction. Requires the multi-MAC compare plan feature. Send X-Idempotency-Key for safe retries; a replayed response carries meta.cached: true.
Parameters
X-Idempotency-Key(header): Unique request identifier for safe retries (recommended)procedure_codes(body, required): CPT/HCPCS codes to compare coverage forpolicy_type(body): Filter by policy type (all Medicare types if omitted)jurisdictions(body): Specific MAC jurisdictions to compare (all if omitted).J01-style codes are normalized toJ1.
Code sources: Code entries in the response carry a source: document when the policy document lists the code, inferred_title_match when the code was attached because the policy title names the drug. See Code sources.
Example request
curl -X POST "https://backworkhealth.com/api/v1/policies/compare" \
-H "Authorization: Bearer $BACKWORK_API_KEY" \
-H "X-Idempotency-Key: $(uuidgen)" \
-H "Content-Type: application/json" \
-d '{
"procedure_codes": [
"76942",
"76937"
]
}'Example response (200)
{
"success": true,
"data": {
"comparison": [
{
"jurisdiction": "string",
"mac": {
"name": "string",
"code": "string",
"jurisdiction_name": "string",
"states": []
},
"policies": [
{}
],
"coverage_summary": {
"covered": 0,
"not_covered": 0,
"requires_pa": 0,
"conditional": 0
}
}
],
"national_policies": [
{
"policy_id": "string",
"title": "string",
"policy_type": "string",
"effective_date": "2026-01-15",
"source_url": "string",
"public_url": "https://backworkhealth.com/policy/L33831",
"source_check": {
"source_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33831",
"last_fetched_at": "2026-01-15T10:30:00Z",
"content_sha256": "9f86d081884c7d659a2feaa0c55ad015a3bf4f1b2b0b822cd15d6c15b0f00a08",
"source_accuracy": []
},
"is_national": true,
"codes": [
{}
]
}
],
"summary": {
"total_jurisdictions": 0,
"jurisdictions_with_coverage": 0,
"national_policies_count": 0,
"has_variation": true,
"queried_codes": [
"string"
],
"requested_jurisdictions": [
"string"
],
"unresolved_jurisdictions": [
"string"
],
"policy_type_filter": "string"
}
},
"meta": {
"request_id": "string",
"timestamp": "2026-01-15T10:30:00Z",
"idempotency_key": "string",
"cached": true
}
}Authorization
bearerAuth API key in format: bwk_live_xxxxx. Keys issued before the rename (vrt_live_) remain valid. bwk_test_ keys work only on the sandbox.
In: header
Header Parameters
Unique request identifier for safe retries (recommended)
Request Body
application/json
TypeScript Definitions
Use the request body type in TypeScript.
Response Body
application/json
application/json
application/json
application/json
application/json
application/json
application/json
application/json
application/json
curl -X POST "https://example.com/policies/compare" \ -H "Content-Type: application/json" \ -d '{ "procedure_codes": [ "76942", "76937" ] }'{ "success": true, "data": { "comparison": [ { "jurisdiction": "string", "mac": { "name": "string", "code": "string", "jurisdiction_name": "string", "states": [ "string" ] }, "policies": [ { "policy_id": "string", "title": "string", "policy_type": "string", "effective_date": "2019-08-24", "source_url": "string", "public_url": "https://backworkhealth.com/policy/L33831", "source_check": { "source_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33831", "last_fetched_at": "2019-08-24T14:15:22Z", "content_sha256": "9f86d081884c7d659a2feaa0c55ad015a3bf4f1b2b0b822cd15d6c15b0f00a08", "source_accuracy": [ { "field": "overall", "sampled_at": "2019-08-24T14:15:22Z", "sample_size": 120, "accuracy": 0.9667, "ci_low": 0.917, "ci_high": 0.987, "method": "manual_review_v1" } ] }, "is_national": true, "codes": [ { "code": "string", "code_system": "string", "disposition": "string", "source": "document", "grounding": "grounded" } ] } ], "coverage_summary": { "covered": 0, "not_covered": 0, "requires_pa": 0, "conditional": 0 } } ], "national_policies": [ { "policy_id": "string", "title": "string", "policy_type": "string", "effective_date": "2019-08-24", "source_url": "string", "public_url": "https://backworkhealth.com/policy/L33831", "source_check": { "source_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33831", "last_fetched_at": "2019-08-24T14:15:22Z", "content_sha256": "9f86d081884c7d659a2feaa0c55ad015a3bf4f1b2b0b822cd15d6c15b0f00a08", "source_accuracy": [ { "field": "overall", "sampled_at": "2019-08-24T14:15:22Z", "sample_size": 120, "accuracy": 0.9667, "ci_low": 0.917, "ci_high": 0.987, "method": "manual_review_v1" } ] }, "is_national": true, "codes": [ { "code": "string", "code_system": "string", "disposition": "string", "source": "document", "grounding": "grounded" } ] } ], "summary": { "total_jurisdictions": 0, "jurisdictions_with_coverage": 0, "national_policies_count": 0, "has_variation": true, "queried_codes": [ "string" ], "requested_jurisdictions": [ "string" ], "unresolved_jurisdictions": [ "string" ], "policy_type_filter": "string" } }, "meta": { "request_id": "string", "timestamp": "2019-08-24T14:15:22Z", "idempotency_key": "string", "cached": true }}Last updated on