API Reference
Get policy by ID
Retrieve a single coverage policy by its ID.
Endpoint: GET /api/v1/policies/{id}
Availability: Live in production.
Authentication: API key in Authorization: Bearer <key> with the read scope.
Retrieve a single coverage policy by its ID. Use include to fetch criteria, codes, attachments, or version history. Policy text sections are fair-use excerpts; the full text is at source_url.
Parameters
id(path, required): Policy ID (e.g., L33831)include(query): Additional data to include (comma-separated: criteria, codes, attachments, versions)
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 GET "https://backworkhealth.com/api/v1/policies/L33831?include=criteria%2Ccodes%2Cattachments%2Cversions" \
-H "Authorization: Bearer $BACKWORK_API_KEY"Example response (200)
{
"success": true,
"data": {
"policy_id": "string",
"title": "string",
"policy_type": "string",
"jurisdiction": "string",
"effective_date": "2026-01-15",
"retire_date": "2026-01-15",
"last_reviewed_date": "2026-01-15",
"version": 0,
"status": "string",
"source_url": "string",
"pdf_url": "string",
"description": "string",
"summary": "string",
"applicability_scope": "shared_markets",
"applicability_markets": [
"string"
],
"applicability_evidence": {
"document_sha256": "string",
"market_index_listings": [
{
"market": "string",
"index_url": "string"
}
],
"document_statements": [
{
"kind": "non_medicare_disclaimer",
"quote": "string",
"page": 0
}
]
},
"applicability_note": "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": [
{
"field": "overall",
"sampled_at": "2026-01-15T10:30:00Z",
"sample_size": 120,
"accuracy": 0.9667,
"ci_low": 0.917,
"ci_high": 0.987,
"method": "manual_review_v1"
}
]
},
"source_shape": "criteria_backed",
"source_shape_reason": "string",
"specialty": [
"string"
],
"keywords": [
"string"
],
"created_at": "2026-01-15T10:30:00Z",
"updated_at": "2026-01-15T10:30:00Z",
"sections": {
"indications": "string",
"limitations": "string",
"documentation": "string"
},
"sections_truncated": true,
"sections_notice": "string",
"mac": {
"name": "string",
"code": "string",
"jurisdiction_name": "string",
"states": [
"string"
]
},
"payer": {
"name": "string",
"code": "string",
"type": "string",
"slug": "molina-healthcare"
},
"criteria": {},
"criteria_count": 0,
"codes": {},
"code_count": 0,
"attachments": [
{
"file_type": "string",
"url": "string",
"title": "string",
"page_number": 0,
"file_size_bytes": 0
}
],
"versions": [
{
"old_version": 0,
"new_version": 0,
"change_type": "string",
"change_summary": "string",
"changed_fields": "string",
"timestamp": "2026-01-15T10:30:00Z"
}
]
},
"meta": {
"request_id": "string",
"timestamp": "2026-01-15T10:30:00Z",
"includes": [
"string"
],
"attributions": {
"disclaimer": "string",
"cpt": "string",
"loinc": "string",
"cms": "string",
"payer_data": "string",
"negotiated_rates": "string"
},
"disclaimer": "string"
}
}Authorization
bearerAuth AuthorizationBearer <token>
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
Path Parameters
id*string
Policy ID (e.g., L33831)
Query Parameters
include?string
Additional data to include (comma-separated: criteria, codes, attachments, versions)
Response Body
application/json
application/json
application/json
application/json
application/json
application/json
application/json
application/json
curl -X GET "https://example.com/policies/L33831"{ "success": true, "data": { "policy_id": "string", "title": "string", "policy_type": "string", "jurisdiction": "string", "effective_date": "2019-08-24", "retire_date": "2019-08-24", "last_reviewed_date": "2019-08-24", "version": 0, "status": "string", "source_url": "string", "pdf_url": "string", "description": "string", "summary": "string", "applicability_scope": "shared_markets", "applicability_markets": [ "string" ], "applicability_evidence": { "document_sha256": "string", "market_index_listings": [ { "market": "string", "index_url": "string" } ], "document_statements": [ { "kind": "non_medicare_disclaimer", "quote": "string", "page": 1 } ] }, "applicability_note": "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" } ] }, "source_shape": "criteria_backed", "source_shape_reason": "string", "specialty": [ "string" ], "keywords": [ "string" ], "created_at": "2019-08-24T14:15:22Z", "updated_at": "2019-08-24T14:15:22Z", "sections": { "indications": "string", "limitations": "string", "documentation": "string" }, "sections_truncated": true, "sections_notice": "string", "mac": { "name": "string", "code": "string", "jurisdiction_name": "string", "states": [ "string" ] }, "payer": { "name": "string", "code": "string", "type": "string", "slug": "molina-healthcare" }, "criteria": { "property1": [ { "block_id": "string", "text": "string", "logic_ast": "string", "tags": [ "string" ], "requires_manual_review": true, "confidence_score": "string" } ], "property2": [ { "block_id": "string", "text": "string", "logic_ast": "string", "tags": [ "string" ], "requires_manual_review": true, "confidence_score": "string" } ] }, "criteria_count": 0, "codes": { "property1": [ { "code": "string", "display": "string", "disposition": "string", "condition_reference": "string", "notes": "string", "source": "document", "grounding": "grounded" } ], "property2": [ { "code": "string", "display": "string", "disposition": "string", "condition_reference": "string", "notes": "string", "source": "document", "grounding": "grounded" } ] }, "code_count": 0, "attachments": [ { "file_type": "string", "url": "string", "title": "string", "page_number": 0, "file_size_bytes": 0 } ], "versions": [ { "old_version": 0, "new_version": 0, "change_type": "string", "change_summary": "string", "changed_fields": "string", "timestamp": "2019-08-24T14:15:22Z" } ] }, "meta": { "request_id": "string", "timestamp": "2019-08-24T14:15:22Z", "includes": [ "string" ], "attributions": { "disclaimer": "string", "cpt": "string", "loinc": "string", "cms": "string", "payer_data": "string", "negotiated_rates": "string" }, "disclaimer": "string" }}Last updated on