Agent skill

Coverage Check

by hh-health-AI in hh-health-AI/healthcare-equity

This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did…

MITAuto-check passed

Install Coverage Check

skills CLI
$ npx skills add hh-health-AI/healthcare-equity --skill coverage-check -a claude-code

Project install by default; add -g for ~/.claude/skills/.

GitHub CLI
$ gh skill install hh-health-AI/healthcare-equity coverage-check --agent claude-code

Project scope by default; add --scope user for a personal install. Needs GitHub CLI 2.90.0 or later (public preview).

Manual copy
$ git clone --depth 1 https://github.com/hh-health-AI/healthcare-equity.git skills-src && mkdir -p .claude/skills && cp -r skills-src/modules/cms-reimbursement/skills/coverage-check .claude/skills/coverage-check && rm -rf skills-src

Use ~/.claude/skills/ instead of .claude/skills for a personal install. The folder must contain SKILL.md.

Claude Code skills documentation · loads skills from .claude/skills/

Facts

Skill name
coverage-check
GitHub stars
101
Token cost
~910 tokens
SKILL.md length
434 words
Files
1
Skills in repo
72
Repo updated
First seen
Licence
MIT

At a glance

This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did…

  • Works in 7 steps: Frame the ask. Identify the product, the… → Search the Medicare Coverage Database… → Classify the position — one of: covered… → …
  • Asks is [drug/device/procedure] covered by Medicare
  • SKILL.md covers Workflow, Quality bar and REMS/ETASU friction check (v0.2)
  • Instructions only: no scripts, shell commands, URLs or credentials in SKILL.md

What it does

Coverage Check is an agent skill from hh-health-AI/healthcare-equity. This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did coverage change for X". Produces a cited Medicare coverage brief with the model variables it moves.

Its SKILL.md is about 910 tokens, which your agent loads only when the skill is triggered. It is a single SKILL.md file with no bundled scripts.

The repository describes itself as: Synthesis engine for buy-side healthcare equity research. The licence is MIT.

When your agent uses it

  • Asks is [drug/device/procedure] covered by Medicare
  • Check the NCD/LCD for X
  • Whats the coverage status of X
  • Any coverage restrictions on X

Example prompts

  • “is [drug/device/procedure] covered by Medicare”
  • “check the NCD/LCD for X”
  • “s the coverage status of X”
  • “/coverage-check”

Workflow steps

7 steps, taken from the first numbered list in SKILL.md.

  1. Frame the ask. Identify the product, the clinical use, the likely site of service (inpatient, HOPD, ASC, office, lab, home), and the…
  2. Search the Medicare Coverage Database via the CMS Coverage connector: national coverage first (NCDs), then local (LCDs and coverage…
  3. Classify the position — one of: covered nationally · covered locally (name the MACs and note geographic gaps) · covered with…
  4. Check for motion. Look for proposed NCDs/reconsiderations, draft LCDs, or recent coverage articles that signal a change window; note the…
  5. Label the universe. State clearly this is Medicare FFS coverage; note that MA plans must cover what NCDs/LCDs cover (but can add…
  6. Translate. Per the coverage row of ${CLAUDE_PLUGIN_ROOT}/references/metrics-payor.md: coverage evidence moves authorization, abandonment…
  7. End with the EVIDENCE BRIEF block (contract in the ${CLAUDE_PLUGIN_ROOT}/CLAUDE.md), with retrieval date and policy vintages. For payment…

What it can do on your machine

Read from SKILL.md and the folder at commit 6c7bda8. It shows what the files ask for, not the result of running them.

  • Tool permissions

    Pre-approves nothing: there is no allowed-tools line, so your agent's usual permission prompts apply.

    From allowed-tools in the SKILL.md frontmatter.

  • Runs code

    No scripts in the folder and no shell commands in SKILL.md.

    From the folder's file list and the shell code blocks in SKILL.md.

  • Network

    No URLs in SKILL.md.

    From URLs in SKILL.md, links to its own repository left out.

  • Credentials

    Names no API keys, tokens, secrets or passwords.

    From names ending in _API_KEY, _TOKEN, _SECRET, _KEY or _PASSWORD in SKILL.md.

Context cost

Coverage Check loads about 910 tokens when it runs. Until then it costs about 78 tokens; SKILL.md has 434 words of instructions outside code blocks.

Always · name and description, kept in context so the agent knows when to use it
~78
When it runs · the whole SKILL.md, loaded when a task matches
~910

Estimates: characters ÷ 4, the usual rule of thumb; real counts depend on the model's tokenizer. Scripts and assets cost tokens only if the agent reads them.

Safety

Auto-check passed

The automated check found no risky patterns in SKILL.md.

Automated static check — not a guarantee. Review scripts before installing. It scans the text of SKILL.md for risky patterns (piping downloads into a shell, reading credential files, hidden Unicode, destructive commands); files beside SKILL.md are not scanned.

SKILL.md

The full file from hh-health-AI/healthcare-equity at commit 6c7bda8, republished under its MIT licence (© hh-health-AI). 434 words, ~910 tokens.

Download SKILL.mdSave it as .claude/skills/coverage-check/SKILL.md (or your agent's skills folder).
name
coverage-check
description
This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did coverage change for X". Produces a cited Medicare coverage brief with the model variables it moves.
metadata.version
0.1.0

Coverage Check

Determine the Medicare coverage position for a named drug, device, diagnostic, or procedure and translate it into model variables.

Workflow

  1. Frame the ask. Identify the product, the clinical use, the likely site of service (inpatient, HOPD, ASC, office, lab, home), and the ticker(s) exposed. If ambiguous, state the assumption and proceed.
  2. Search the Medicare Coverage Database via the CMS Coverage connector: national coverage first (NCDs), then local (LCDs and coverage articles by MAC). Capture: policy ID and title, national vs local, effective/retirement dates, covered indications and restrictions (patient criteria, physician/site requirements, frequency limits, documentation), and Coverage with Evidence Development (CED) conditions if any.
  3. Classify the position — one of: covered nationally · covered locally (name the MACs and note geographic gaps) · covered with restrictions/CED · explicitly non-covered · silent (no policy — contractor discretion; for new technology, silence plus a new code often means case-by-case review).
  4. Check for motion. Look for proposed NCDs/reconsiderations, draft LCDs, or recent coverage articles that signal a change window; note the comment/decision dates as catalysts for the catalyst calendar.
  5. Label the universe. State clearly this is Medicare FFS coverage; note that MA plans must cover what NCDs/LCDs cover (but can add utilization management), and commercial coverage is separate — if the thesis needs it, do targeted web research on the top commercial payors' medical policies and mark that as a separate evidence line.
  6. Translate. Per the coverage row of ${CLAUDE_PLUGIN_ROOT}/references/metrics-payor.md: coverage evidence moves authorization, abandonment, paid conversion, and net price/accessible population. It does not automatically move clinical adoption or prescribing — say so.
  7. End with the EVIDENCE BRIEF block (contract in the ${CLAUDE_PLUGIN_ROOT}/CLAUDE.md), with retrieval date and policy vintages. For payment rates, hand off to the reimbursement-impact skill — coverage and payment are different questions.
Show full SKILL.md (143 more words)Show less

Quality bar

Quote restriction language exactly when it drives the model (e.g., patient-criteria clauses that halve the eligible population). Never infer coverage from the absence of a policy without labeling it "silent/contractor discretion". If results are thin or ambiguous, say "missing" and name the data point that would settle it (e.g., MAC call, payor policy portal).

REMS/ETASU friction check (v0.2)

For drug products, check whether a REMS program — especially ETASU elements (prescriber/pharmacy certification, patient registries, required monitoring, restricted distribution) — sits between coverage and paid demand. REMS friction is quantifiable access friction: per the coverage translation row, it moves authorization, abandonment, and paid conversion, and functions as an accessible-population/uptake-pace haircut in the funnel (not a qualitative caveat). Note REMS changes (additions, modifications, removals) as dated demand-side events for the catalyst feed, and cross-reference the clinical-catalysts quality-signals skill when a safety development could trigger one.

© hh-health-AI, MIT. Rendered from Markdown: HTML in the file is shown as text, images as links, and headings moved down two levels. Raw file

Files

Just SKILL.md in modules/cms-reimbursement/skills/coverage-check of hh-health-AI/healthcare-equity.

Open the folder on GitHubat commit 6c7bda8

Compare with similar skills

Coverage Check next to the 5 skills that share the most tags, products or categories with it. Stars are the repository's; “used in” counts other GitHub owners with a copy.

Coverage Check compared with similar skills
SkillStarsUsed inTokensAuto-checkLicenceRepo updated
Coverage Check this skillhh-health-AI/healthcare-equity101—~910Automated safety check: PassMIT
Coveragealirezarezvani/claude-skills28k1 repos~669Automated safety check: PassMIT
Coveragepydantic/monty8.6k—~282Automated safety check: PassMIT
CoverageLiberatedPixelCup/Universal-LPC-Spritesheet-Character-Generator1.8k—~1.8kAutomated safety check: PassGPL-3.0
CoverageLog2n-io/Typhon250—~787Automated safety check: PassCustom licence
CoverageAmplicode/spring-skills128—~526Automated safety check: PassNone

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Questions about Coverage Check

What does Coverage Check do?

This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did…. Coverage Check is an agent skill from hh-health-AI/healthcare-equity. This skill should be used when the user asks "is [drug/device/procedure] covered by Medicare", "check the NCD/LCD for X", "what's the coverage status of X", "any coverage restrictions on X", or "did coverage change for X".

When should I use Coverage Check?

Coverage Check fits situations like: asks is [drug/device/procedure] covered by Medicare; check the NCD/LCD for X; whats the coverage status of X; any coverage restrictions on X.

How do I install Coverage Check in Claude Code?

Run `npx skills add hh-health-AI/healthcare-equity --skill coverage-check -a claude-code`. Or copy the skill folder (modules/cms-reimbursement/skills/coverage-check in hh-health-AI/healthcare-equity) into .claude/skills/coverage-check in your project. Claude Code loads it when a task matches its description.

How do I install Coverage Check in Codex?

Run `npx skills add hh-health-AI/healthcare-equity --skill coverage-check -a codex`. Or copy the skill folder (modules/cms-reimbursement/skills/coverage-check in hh-health-AI/healthcare-equity) into .agents/skills/coverage-check in your project. Codex loads it when a task matches its description.

Can I use Coverage Check in Cursor, Gemini CLI or GitHub Copilot?

Cursor, Gemini CLI, GitHub Copilot and OpenCode also load SKILL.md folders. With the skills CLI, run `npx skills add hh-health-AI/healthcare-equity --skill coverage-check -a cursor` (or -a gemini-cli, github-copilot or opencode for the others). To copy it by hand, put the folder in .cursor/skills/coverage-check, .gemini/skills/coverage-check, .github/skills/coverage-check and .opencode/skills/coverage-check in your project.

What does Coverage Check need to run?

SKILL.md names no scripts, command-line tools or credentials: Coverage Check is instructions for the agent only.

Does Coverage Check access the network?

SKILL.md contains no URLs. Any network use would come from the scripts or tools the agent runs. This is read from the text; nothing was executed.

Is Coverage Check safe to install?

Our automated static check of SKILL.md found no risky patterns, such as piping downloads into a shell, reading credential files or hidden Unicode. It is not a guarantee. Review the folder before installing.

What licence does Coverage Check use?

Coverage Check is published under the MIT licence (the repository's licence). It allows redistribution, so the full SKILL.md is shown on this page.

How many tokens does Coverage Check use?

About 910 tokens (SKILL.md is roughly 3.6k characters). Agents keep only the skill's name and description in context until a task matches; then they load SKILL.md in full.

What are the alternatives to Coverage Check?

Skills that share tags, products or a category with Coverage Check: Coverage (alirezarezvani/claude-skills, 28k stars), Coverage (pydantic/monty, 8.6k stars), Coverage (LiberatedPixelCup/Universal-LPC-Spritesheet-Character-Generator, 1.8k stars) and Coverage (Log2n-io/Typhon, 250 stars). The comparison table on this page puts their stars, adoption, token cost, safety result and licence side by side.

Who maintains Coverage Check?

hh-health-AI (a GitHub user) maintains it in hh-health-AI/healthcare-equity, which has 101 GitHub stars. The repository holds 72 skills in this directory. The repository was last updated on October 8, 2026.

Source: hh-health-AI/healthcare-equity on GitHub. Facts on this page come from the repository at the commit we read; the author's words are quoted as theirs.