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. In addition, variance between actual Medicare payment and a PC Pricer estimate may exist due to a 3-month lag in quarterly updates to provider data. In such situations, the PC Pricer 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.
Delay in 2013 PC Pricers for Claims Effective October 1, 2012 and/or January 1, 2013:
Please be advised that CMS anticipates delays for all of the FY 2013 PC Pricer releases (LTCH, SNF and ESRD). CMS is in the process of transitioning to new software products to support the back-end development of all of the PC Pricers. This transition is expected to increase the initial development time. Executable files will be made available once the transition is complete, sometime between May 15 and June 30, 2013.
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. Finally, the PRICERS can run in a network environment.
For each new release of the PRICERS, the Provider Specific File will contain all quarterly updates. Each new release will replace any previous release.
For a given fiscal year, the PRICER release schedule is as follows:
- First Quarterly Release — On or about October 15
- Second Quarterly Release — On or about January 15
- Third Quarterly Release — On or about April 15
- Fourth Quarterly Release — On or about July 15
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).
- Page last Modified: 05/15/2013 7:46 AM
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