Medicaid

Changed on Nov 3, 2026

post/v1/medicaid

Request

Base URL
https://coverage-api.meetnirvana.com
URL
https://coverage-api.meetnirvana.com/v1/medicaid
Auth
none declared

Request body

cpt_codestring

CPT (Current Procedural Terminology) code

member_dobstring date required

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

member_first_namestring required

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

member_gender'M' | 'F'

member_idstring

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

member_last_namestring required

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

modality_code'PMC' | 'PHT' | 'PSC' | 'PSY' | 'MRI' | 'HST' | 'MNT' | 'CT' | 'IOP' | 'PHP' | 'UC' | 'ABA' | 'OBG' | 'MAT' | 'ORP' | 'DER' | 'GI' | 'ST' | 'CAR' | 'OT' | 'LAB'

next_appointmentstring date

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

office_idstring

An identifier for the office or location being visited.

patient_idstring

Patient's id

patient_statestring

Patient's state

patient_type'PROSPECT' | 'NEW_PATIENT' | 'EXISTING_PATIENT'

payer_idstring

Payer ID used to verify benefits

provider_npistring required

Service Provider's 10-character NPI

provider_pinstring password

Provider PIN for MDCAL payer only

with_alertsboolean

If true, return the list of OneVerify alerts

Example request

{
  "cpt_code": "90834"
}

Response

Successful Response

Example response

{
  "plan_begin_date": "2021-01-01",
  "plan_end_date": "2022-01-01",
  "relationship_to_subscriber": "Self"
}

Changes

Nov 3, 2026f90ee559b8c7 Revision changes
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the // response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_DATE_OF_BIRTH enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the // response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_MEMBER_NAME enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the // response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new MISMATCH_ZIP_CODE enum value to the / response property for the response status
- warning
  added the new ORIGINAL_MEDICARE enum value to the // response property for the response status
- warning
  added the new SUPPLEMENTAL_MEDICARE enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the // response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new TIMEOUT enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the // response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- warning
  added the new UNABLE_TO_FIND_ACTIVE_COVERAGE enum value to the / response property for the response status
- info
  added the new optional request property
- info
  removed the MISSING_FINANCIALS enum value from the // response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the MISSING_FINANCIALS enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the // response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status
- info
  removed the NOT_YET_IMPLEMENTED enum value from the / response property for the response status

Operation history