Medicaid

post

https://coverage-api.meetnirvana.com/v1/medicaid

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Medicaid Product Support by State

Please use the following table as a reference for the member ID requirement by state:

State	Support	Member ID Required?	Gender Required if No Member ID?
Alabama	✅	No
Alaska	✅	Yes
Arizona	✅	No
Arkansas	✅	No
California	✅* (PIN required)	Yes
Colorado	✅	No
Connecticut	✅	Yes
Delaware	✅	No
Florida	✅	No	Yes
Georgia	✅	No	Yes
Hawaii	✅	No	Yes
Idaho	✅	No
Illinois	✅	No
Indiana	✅	No
Iowa	✅	No
Kansas	✅	No
Kentucky	✅	No	Yes
Louisiana	✅	No
Maine	✅	No
Maryland	✅	Yes
Massachusetts	✅	No	Yes
Michigan	✅	No
Minnesota	✅	No
Mississippi	✅	No
Missouri	✅	No
Montana	✅	No
Nebraska	✅	Yes
Nevada	✅	No
New Hampshire	✅	No
New Jersey	✅	No
New Mexico	✅	No
New York	✅	Yes
North Carolina	✅	No
North Dakota	✅	No
Ohio	✅	No
Oklahoma	✅	No
Oregon	✅	No
Pennsylvania	✅	No
Rhode Island	✅	Yes
South Carolina	✅	No
South Dakota	✅	Yes
Tennessee	✅	No
Texas	✅	No
Utah	✅	Yes
Vermont	✅	Yes
Virginia	✅	No
Washington	✅	No
West Virginia	✅	No
Wisconsin	✅	No
Wyoming	✅	No	Yes
Washington DC	✅	No

Body Params

cpt_code

string

CPT (Current Procedural Terminology) code

member_dob

date

required

Member's date of birth provided in yyyy-mm-dd format

member_first_name

string

required

Member's first name; as printed on the insurance card.

member_gender

string

enum

Legal gender, as printed on the insurer card or government ID

Allowed:

member_id

string

Member's unique insurance ID, as printed on the insurance card

member_last_name

string

required

Member's last name; as printed on the insurance card.

modality_code

string

enum

Defaults to PSY

Modality code

next_appointment

date

Patient's next appointment date in yyyy-mm-dd format

office_id

string

An identifier for the office or location being visited.

patient_id

string

Patient's id

patient_state

string

Patient's state

patient_type

string

enum

Patient's type

Allowed:

payer_id

string

Payer ID used to verify benefits

provider_npi

string

required

length between 10 and 10

Service Provider's 10-character NPI

provider_pin

password

Provider PIN for MDCAL payer only

with_alerts

boolean

Defaults to false

If true, return the list of OneVerify alerts

Responses

Medicaid Product Support by State

200Successful Response

400Bad Request

401Unauthorized

404Not Found

422Unprocessable Entity

429Too Many Requests

500Internal Server Error

502Bad Gateway

504Gateway Timeout