Twilio for AI provides coding agents with skills and an MCP server for using Twilio services and documentation. The MCP server searches Twilio documentation and API specifications and retrieves full schemas for selected operations, while the skills supply procedural guidance to agents. Its catalogue add-ons are intended for Claude Code, Cursor, Codex, and other tools that support the Agent Skills standard.
Getting it into your agent
One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.
npx skills add twilio/ai --skill twilio-security-compliance-hipaagit clone --depth 1 https://github.com/twilio/aiWrote this? Show the measurements
A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.
[](https://agentmods.dev/skills/twilio/ai/twilio-security-compliance-hipaa)<a href="https://agentmods.dev/skills/twilio/ai/twilio-security-compliance-hipaa"><img src="https://agentmods.dev/badge/skills/twilio/ai/twilio-security-compliance-hipaa/github.svg" alt="Measured on agentmods" height="20"></a>Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.
<a href="https://agentmods.dev/skills/twilio/ai/twilio-security-compliance-hipaa"><img src="https://agentmods.dev/badge/skills/twilio/ai/twilio-security-compliance-hipaa.svg" alt="Reviewed on agentmods" width="80" height="20"></a>- NVIDIA SkillSpector pass
What it costs to keep this loaded
Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.
| Model | Per session | Once invoked |
|---|---|---|
| Fable 5.1 | $0.00078 | $0.01755 |
| Opus 5 | $0.00039 | $0.00877 |
| Sonnet 5 | $0.00016 | $0.00351 |
| Haiku 4.5 | $0.00008 | $0.00176 |
Grade A, and why
twilio-security-compliance-hipaa scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 12d ago.
A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.
Nothing flagged
None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.
How it starts
The opening of the file, as written. The whole thing — 149 lines — stays where its author put it; the contents beside it link to each section on GitHub.
Overview
HIPAA compliance on Twilio is a shared responsibility — Twilio provides eligible services and configuration tools, but your application must architect correctly. Getting this wrong means PHI exposure and compliance violations.
Sequence: Execute BAA → Designate HIPAA Project(s) → Use only eligible services → Follow per-product requirements
Step 1: Execute a BAA
- Contact your Twilio Account Representative to execute a Business Associate Addendum
- Purchase a Twilio Editions package that includes HIPAA Accounts
- BAA is required before any PHI touches Twilio infrastructure
Step 2: Designate HIPAA Project(s)
Self-Service (BAA initiated after June 6, 2024)
- Create an Organization in Twilio Console
- Link accounts/projects/subaccounts to the Organization
- Console → Twilio Admin → Accounts → Select account → Enable HIPAA flag
- Save
Support Ticket (BAA initiated before June 6, 2024)
Open a Support ticket through Console to request HIPAA designation for specific accounts/projects/subaccounts.
Subaccount Behavior
- Existing subaccounts are NOT auto-designated — Must be individually flagged
- New subaccounts created AFTER designation DO auto-inherit HIPAA status
- Verify each subaccount's HIPAA flag — don't assume inheritance
What Changes When HIPAA Is Enabled
- Console auto-logoff after 15 minutes of inactivity
- Account exempt from certain content moderation (but still subject to carrier complaint review)
- No PHI in support tickets — use SIDs (CallSid, MessageSid) instead of phone numbers
HIPAA Eligible Services
Eligible (use these for PHI workflows)
| Category | Services |
|---|---|
| Voice | Programmable Voice, Recordings*, Transcription*, Media Streams*, ConversationRelay*, Conversational Intelligence for Voice*, SIP Interface*, Elastic SIP Trunking*, Voice Insights, AMD, <Pay>, Conference, Coaching, Transfers |
| SMS | Programmable SMS, MMS, Long Codes, Toll-Free, Short Codes, Messaging Services (opt-out, fallback, geomatch, sticky sender, scheduling, link shortening) |
| Identity | Verify (SMS + Voice + Push only), Lookup |
| Conversations | Chat, SMS, MMS, Group Texting (NOT WhatsApp) |
| Flex | Voice, SMS, Chat, Conversations, Webchat 3.x.x*, TaskRouter, Proxy, Flex Insights* |
| Segment | Connections (Sources, Destinations*, Functions*), Reverse ETL*, Unify, Engage Foundations*, Protocols, Privacy Portal* |
| Runtime | Studio*, Functions, Debugger, API Explorer, Sync, Private Assets*, TwiML Bin* |
| Data | Event Streams |
What ships with it
3 files beside SKILL.md in the same directory: the scripts, references and assets a skill reads on demand. Not counted in the per-session cost; read them before you install if any of them is executable.
What this file has done since we first saw it
Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.
- 12d ago First seen · 149 lines · 78 tokens per session scan A 7e5ec753e5e7
twilio-security-compliance-hipaa is a skill published in the GitHub repository twilio/ai (32 stars, last pushed 27d ago), licensed MIT. It adds 78 tokens to every session and 1,755 once invoked, about $0.0004 per session on Opus 5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.
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