Although PPS pricers are available for individual claim pricing on the Medicare
website, Medicare does not provide a “ready to use” batch pricing version of the PPS
Pricers. This makes repricing a pain for smaller organizations and providers that need
to assign prices and view logic on dozens or hundreds of claims at a time.
We’ve replicated the CMS pricing logic for the following PC Pricers below:
Inpatient PPS Pricer (IPPS)
Outpatient PPS Pricer (OPPS)
Hospice PPS Pricer
Inpatient Psychiatric PPS Pricer
Inpatient Rehab PPS Pricer
Long Term Care PPS Pricer
Skilled Nursing (SNF) PPS Pricer
ESRD PPS Pricer
FQUHC PPS Pricer
Work with us in a way that works for you
One off engagement (send us a batch of de-identified claims data, and we’ll assign pricing)
Via a batch pricing API (integrate Medicare pricing into your system without ever leaving your software)
Subscription licensing (pay to price claims by month – with unused credit rolling over to the next month)
Is this product for you?
Medicare pricing affects providers and vendors all throughout healthcare. Contact us
today if you’re an organization that wants to know what’s owed from CMS:
Law firms
Providers
TPAs
Software vendors
Consultants
Have questions about the Medicare Batch Pricing Engine?