Our Medicare Endpoints

The preferred API Endpoints for Medicare Solutions.

Medicare DME Same or Similar APIs

pVerify® showcases the most dynamic and robust Same or Similar APIs for all 4 jurisdictions

DME Same or Similar APIs


For DME Suppliers working with Medicare patients, Same or Similar is a valuable step in the process to ensure payment for every device issued. Specifically, pVerify’s Same or Similar refers to a patient’s 5-year Claim History for a device category and the discovery if the same device, or a similar one, has already been provided to the patient within 5 years.

pVerify’s consumable API endpoints are a near real-time calls from a client’s own system, sent to pVerify and through to obtain a Medicare patient’s claim history. The API get then returns to pVerify for parsing and then back to the pVerify client, within a matter of seconds.

The Best Healthcare APIs 

pVerify’s robust APIs are available for the following services

Same or Similar API

pVerify has two RESTful API end points to give Same or Similar HCPCS(L code) Status information,

This workflow is:

  • Get Token via Token call.
  • Call SameOrSimilarInquiry and pass the token along with demographic information.
  • Call GetSameOrSimilarResponse/{requestId} later to get the results and pass the token.

Note : Same Token can be used in subsequent inquiries.

Examples of Medicare DME Same or Similar API Results

  • Full Claim History for Device Categories: A, B, E, K, & L.
  • Confirmation if a previous HCPCS claim was approved or if none were found
  • Date a specific HCPCS was issue
  • Full Claim History in response regardless if all HCPCS are sent in the API Call
  • Interpretive Flag to decipher if a similar item was previously issued (prevention flag)
  • Optional client-level preference to return only SAME CATEGORY of claims, ie CGM devices if you submit CGM HCPCS, and not wheelchairs.  

The Best Healthcare APIs 

pVerify’s robust APIs are available for the following services

Recursive Medicare Advantage

Verify a Medicare Advantage Payer automatically from a Medicare transaction, using our proprietary methods, and obtain the MA Plan Subscriber ID and coverage details

Advanced Eligibility

An Eligibility API Call will verify a patient in real-time with unique parsing of benefits.  

Supporting ANSI X12 for consumption of detailed Summary Endpoint 

Inpatient SNF

Discover if a patient is currently admitted to a Hospital or Skilled Nursing Facility (SNF)

Experts in APIs

With hands-on and responsive Healthcare Eligibility API Support, pVerify assists with designing your Healthcare API workflow, acts as a hand-on guide throughout development, and remains a go-to expert post development.

Realtime Healthcare API Eligibility API