ESRD PC Pricer

COBOL Personal Computer (PC) Pricers Conversion To Java Web Based Applications

Please advise. Providers and other payers use PC Pricer applications to estimate Medicare payments. Over the next year, CMS will stop producing new versions of the downloadable PC Pricers and issue them as web-based applications. CMS will continue to communicate the status of each PC Pricer conversion with our users as each Web based Pricer becomes available. 

FY2021 ESRD PC Pricer Temporarily Unavailable For Download

Users should be advised that the FY2021 ESRD PC Pricer is temporarily unavailable for downloading at this time. CMS will continue to communicate the release status of FY 2021 ESRD PC Pricer when it's available for public use.

Section 1881 (b)(12) of the Social Security Act, as amended by section 623 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, establishes the End Stage Renal Disease (ESRD) composite rate payment method for most dialysis related services provided by renal dialysis facilities to Medicare beneficiaries with end stage renal disease. 

This PC Pricer software allows users to enter information to predict reimbursement to a renal dialysis facility based on the type of dialysis and various patient characteristics.  It contains the same payment logic used to calculate composite rate payments for type of bill 72x in the Medicare mainframe system.

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Page Last Modified:
04/08/2021 03:23 PM