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Provider Directory

Covered Drugs Formulary

PSM Interoperability

API Developer Portal

This website gives instructions for application (“app”) developers to learn how to connect and use the Patient Access API and Provider Directory API to make our Beneficiaries’ data available to them through the applications they use.

PSM Interoperability API Developer Portal provides third-party app developers with access to documentation, registration services and Developer Sandbox platform, pursuant to the Centers for Medicare & Medicaid Services (“CMS”) Interoperability and Patient Access Final Rule (CMS-9115-F).

Since your application will have access to an individual’s beneficiary health data, this API requires that your application be registered with PSM.  Once registered, the PSM API uses authorization and authentication protocols.

Please create an account in our developer portal to allow our Beneficiaries to receive their health plan data through your application.  The API benefits includes:

      • The Patient Access API to retrieve, with the approval and at the direction of an applicable PSM member or the member’s personal representative, certain data, as applicable, concerning adjudicated claims, encounter data, formulary data, and certain clinical data, if PSM maintains any such data.
      • The Provider Directory API to retrieve, as applicable, certain PSM provider directory information.
      • The developer sandbox services to test your application’s connection to the APIs.

Register your app here to access the Patient Access API.

Terms of Service
Compliance and agreement to our Terms of Service is required to access and use Interoperability APIs. Our terms of service are compliant with data blocking and other CMS rules pertaining to access.