Skip to Main Content

PC Pricer

The PC Pricer is a tool used to estimate Medicare PPS payments. The final payment may not be precise to how payments are determined in the Medicare claims processing system due to the fact that some data is factored in the PC Pricer payment amount that is paid by Medicare via provider cost reports. A variance between actual Medicare payment and a PC Pricer estimate may exist as there is typically a 3-month lag in quarterly updates to provider data. Likewise, due to the approximate 3-month lag time, the absence of a record for any given provider in the Provider Specific file that accompanies the PC Pricers DOES NOT necessarily imply that the missing provider is not enrolled in Medicare and/or is not eligible for payment under Medicare.  In such situations, the PC Pricers offer flexibility by allowing users to modify provider data to reflect different values.  Users are encouraged to refer to the User Manual for the applicable Pricer to access downloading and data entry instructions.

Required One-time Installation of Fujitsu NetCOBOL Run Time Files

In order to successfully install and run any of the PC Pricer software (posted on the CMS website after January 2013) including End Stage Renal Disease Facilities (ESRD), Home Health (HHA), Inpatient Facilities (IPPS), Inpatient Psychiatric Facilities (IPF), Inpatient Rehabilitation Facilities (IRF), Long Term Care Hospitals (LTCH) and Skilled Nursing Facilities (SNF), a one-time installation of Fujitsu NetCOBOL run time files is required. The Fujitsu NetCOBOL run time files can be found packaged with each zipped PC Pricer file for downloading.  Instructions for downloading Fujitsu NetCOBOL run time files can be found in section one of the “PC Pricer Download Instructions.” These instructions may be accessed through the following link: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PCPricer/Downloads/Updated-PCPricer-Download-Instructions.pdf.

System Requirements:

The PRICERs can be installed in a Windows environment. You will need an IBM PC or clone with a hard disk drive for Microsoft Windows Version 95 or greater with at least 8MB RAM. Both monochrome and color monitors are supported. A printer is essential to produce the report that displays the PRICER results. 

Provider Center

For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) providers, including physicians, other practitioners and suppliers, go to the Provider Center (see under "Related Links Inside CMS" below).