Payerset API Documentation

Welcome to the Payerset API documentation. This API provides a comprehensive solution for accessing healthcare data, including provider and billing code metadata, healthcare rates, and other critical reference information that supports data transparency and price comparison for health services.

Overview

Payerset’s API is designed to facilitate streamlined access to healthcare-related data. It’s built with a focus on price transparency, rate benchmarking, and contract negotiation across healthcare services. The API enables healthcare consulting firms, insurance companies, and other stakeholders to retrieve and leverage various data points efficiently.

Key Capabilities

• Provider Metadata: Access detailed information about healthcare providers, including National Provider Identifier (NPI) details, organization names, taxonomies, geographic data, and Medicare-specific classifications.

• Billing Codes: Retrieve metadata associated with healthcare billing codes (e.g., CPT codes) including code descriptions, categories, and specialties.

• Healthcare Rates: Retrieve negotiated healthcare rates by provider, payer, and billing code, supporting use cases in benchmarking and price transparency efforts.

Base URL

The API is hosted at: https://api.payerset.com/v1/

Postman Spec Download

You can download the Postman collection for this API from the following link: https://content.payerset.com/payerset-api-postman-spec

Authentication

This API requires an API key for authentication. Include your API key in the x-api-key header with every request: x-api-key: YOUR_API_KEY

Key Endpoints

Provider Metadata

/v1/metadata/npi_detail

Get detailed metadata about a provider based on NPI.

/v1/metadata/billing_code

Retrieve metadata about specific billing codes, including category, subcategory, and description.

Healthcare Rates

/v1/rates

Retrieve negotiated rates for healthcare services based on provider NPI, payer, and billing code. Each response includes the negotiated rate, billing code details, billing class, and service codes.

Usage Example

Fetching Rates

Endpoint

GET /v1/rates

Query Parameters

npi (required): National Provider Identifier. payer (required): Name of the payer (e.g., “Aetna”). billing_code (required): Billing code of the service (e.g., “27447” for Total Knee Arthroplasty).

Sample Request

const response = await fetch('https://api.payerset.com/v1/rates?npi=1003936113&payer=aetna&billing_code=27447', {
    method: 'GET',
    headers: {
      "x-api-key": "YOUR_API_KEY"
    },
});
const data = await response.json();

Additional Resources

For comprehensive usage guidelines, examples, and parameter details, visit the full documentation at: https://api-docs.payerset.com

Contact Us

If you have any questions or need assistance, please reach out to our support team at [email protected].

Ths API documentation is a part of Payerset’s commitment to advancing healthcare price transparency and supporting data-driven decisions across the industry.