{
  "name": "payer-price-transparency-mcp",
  "title": "HealthMesh · Payer Price Transparency (TiC) MCP",
  "version": "0.1.2",
  "description": "Transparency in Coverage (TiC) payer machine-readable files: search UnitedHealthcare's public TiC catalog (~68k employer/plan table-of-contents files and ~7.3k in-network rate files, bundled index), read any payer's table-of-contents by URL, and stream-scan small in-network and allowed-amount files on demand for one billing code. Most in-network files are 1–20+ GB and are not ingested (Partial). CPT descriptors are never served.",
  "healthmesh_domain": "Price Transparency & Cost",
  "datasets": [
    "PRICE-02"
  ],
  "mcp_endpoint": "https://payer-price-transparency.healthmesh.ai/mcp",
  "transport": "Streamable HTTP (stateless, JSON responses)",
  "authorization": "none",
  "auth_mode": "off",
  "docs": "https://github.com/HendrikK/healthmesh/tree/main/servers/payer-price-transparency-mcp#readme",
  "contact": "hendrik.kleine@gmail.com",
  "data_source": {
    "name": "Transparency in Coverage machine-readable files (45 CFR 147.212) — UnitedHealthcare public TiC catalog + any payer TOC/file URL",
    "url": "https://github.com/CMSgov/price-transparency-guide",
    "license": "Payer-published public files required by federal rule; CMS schema U.S. Government work",
    "refresh": "UHC catalog bundled (monthly GitHub Actions check of the blob listing); TOC/in-network/allowed-amount files read live on demand"
  },
  "tools": [
    {
      "name": "tic_list_payer_files",
      "title": "List a payer's TiC table-of-contents entries",
      "description": "Lists Transparency in Coverage table-of-contents (TOC) entries: reporting plans (name, id, market type, sponsor) with their in-network rate file URLs (with gzip size and whether this server can scan it) and allowed-amount file URL. UnitedHealthcare (incl. UMR, Golden Rule, Oxford and TPAs hosted on UHC's site) is searchable by employer/plan sponsor name from a bundled catalog of ~68k TOC files; matching TOCs are then read live. Any other payer: pass its TOC URL as toc_url. Use in_network_file_contains to search UHC's ~7.3k in-network file names directly (e.g. 'Choice-Plus', 'HealthSCOPE')."
    },
    {
      "name": "tic_get_negotiated_rates",
      "title": "Negotiated rates for a billing code (TiC in-network file)",
      "description": "Returns negotiated rates for one billing code from a payer's TiC in-network file, flattened to one row per negotiated price with provider NPIs/TINs resolved from provider_references, filtered by NPI, TIN, billing class and place-of-service code. Pass in_network_file_url (any payer; from tic_list_payer_files), or payer_name=UnitedHealthcare + plan_name to resolve the employer's TOC (the 3 smallest scannable files are scanned). Files over 15 MB gzip are reported as file_too_large, not scanned. CPT codes are identifiers only."
    },
    {
      "name": "tic_get_allowed_amounts",
      "title": "Out-of-network allowed amounts for a code (TiC allowed-amount file)",
      "description": "Returns out-of-network allowed amounts and billed charges a payer reported for one billing code (payers only report a code/provider when there were ≥20 claims in the 90-day period, so most files are empty). Pass allowed_amount_file_url (any payer), or payer_name=UnitedHealthcare + plan_name to use that employer's allowed-amount file from its TOC."
    },
    {
      "name": "tic_compare_payer_rates",
      "title": "Compare negotiated rates for a code across TiC files",
      "description": "Compares negotiated rates for one billing code across 2–4 TiC in-network files (e.g. different payers or networks), optionally for one provider NPI, with per-file and overall min/median/max. Market-wide (state/CBSA) comparison is not built: there is no ingested rate database."
    },
    {
      "name": "tic_describe_dataset",
      "title": "Describe the TiC payer price transparency sources",
      "description": "Describes the bundled UnitedHealthcare TiC catalog, on-demand scan limits, other payers' TiC landing pages, the CMS TiC schema, and known gaps."
    }
  ]
}