BillingBench API · v1

The BillingBench API provides verified payer policy data with full provenance for developers building AI billing tools, RCM automation, and clinical decision support applications. Every record includes the policy citation, source URL, verification date, and a changelog tracking policy changes over time. PHI-zero by design — no patient identifiers, no practice IDs, no claim data in any API response.

Five live endpoints in public beta: GET /api/v1/policy (payer medical policy lookup by payer and CPT code or citation number), GET /api/v1/denial-pathway (denial decision pathways by specialty, payer, and CPT), GET /api/v1/prior-auth (prior authorization requirements by specialty, payer, and CPT), GET /api/v1/modifier (payer-specific modifier rulings by CPT and modifier combination), GET /api/v1/signals (behavioral signal data — aggregate denial rate and collection rate by payer and CARC code, sourced from the cross-practice 835 ERA upload network).

Rate limits: 100 requests/hour without a key (anonymous), 1,000/hour for registered developer keys, 10,000/hour for enterprise keys. Anonymous responses include full policy text and citations. API key registration is available at /developers for developer-tier access. The interactive API playground on this page allows live queries against all five endpoints without writing code. Each response includes policy text, citation, source URL, last_verified timestamp, next_review date, and changelog.

• Operations plan — API access included for billing companies
• About BillingBench — data sourcing and methodology
• Security architecture and compliance