@upstream-intelligence/cli

Releases: npm | CHANGELOG

Free healthcare billing intelligence from your terminal.

Decode CARC denials, check NCCI edits, look up CMS fee schedules, pull payer scorecards, scrub claims, and hit federal free data (NPPES, NIH, Federal Register) without leaving your shell. No auth for public tools.

Install

npx -y @upstream-intelligence/cli --help

Or globally:

npm i -g @upstream-intelligence/cli
upstream --help

Quickstart

# Decode a denial code
upstream carc CO-197

# Check bundling between two procedures
upstream ncci 97110 97140

# CMS fee schedule, with optional locality
upstream fee 99213
upstream fee 99213 --locality 01112

# Payer scorecards
upstream payer aetna
upstream payers --vertical aba
upstream compare aetna cigna anthem

# Scrub a claim (claim.json on disk)
upstream scrub claim.json

# Explain a denial with recommended appeal
upstream explain CO-197 aetna

# Federal free data
upstream npi 1234567890
upstream providers --last Smith --state NY --taxonomy "Internal Medicine"
upstream icd10 "type 2 diabetes"
upstream hcpcs J3490
upstream fedreg "prior authorization"

# Health check
upstream status

Configuration

| Variable | Default | Purpose | |---|---|---| | UPSTREAM_API_BASE | https://api.upstream.cx/api/v1 | Point at a different Upstream instance. | | UPSTREAM_API_KEY | (unset) | If set, sent as X-API-Key on every request to the Upstream API. Raises your rate limit from 500 calls/month (free tier) to your plan tier. Never sent to public federal data sources (NPPES, NIH, Federal Register). |

Exit codes

| Code | Meaning | |---|---| | 0 | Success. Clean JSON on stdout. | | 1 | Network or HTTP error. Error envelope JSON on stderr: {status, url, hostname, retry_after, message}. | | 2 | Bad usage (missing args, unknown command). Usage text on stderr. |

Sample claim.json

{
  "cpt_codes": ["97153", "97155"],
  "dx_codes": ["F84.0"],
  "payer": "aetna",
  "service_date": "2026-03-15",
  "modifiers": [],
  "units": 8,
  "billed_amount": 440.00
}

Pipe it

upstream payers --vertical aba | jq '.[].name'
upstream icd10 "sepsis" | jq '.results[] | .code + " " + .description'
upstream scrub claim.json | jq '.findings[] | select(.severity=="error")'

Links

• Developer docs: upstream.cx/developers
• Source: github.com/byteworthy/Upstream/tree/main/packages/cli
• MCP equivalent: @upstream-intelligence/mcp for AI agents

License

MIT.