Provider Statistical and Reimbursement (PS&R) System
The Provider and Statistical Reimbursement (PS&R) System is a key tool for institutional healthcare providers, Medicare Administrative Contractors (MACs) and CMS. The system accumulates statistical and reimbursement data applicable to the processed and finalized Medicare Part A claims. This data is summarized in various reports, which are used by providers to prepare Medicare cost reports, and by MACs during the audit and settlement process.
The CMS has redesigned the PS&R system and the new system (PS&R Redesign) is a web-based, centralized system, housed at CMS. The previous PS&R (Legacy PS&R) is housed at each MAC. The PS&R Redesign shall be utilized to file and settle all cost reports with fiscal years ending January 31, 2009 and later. All cost reports with fiscal years ending prior to January 31, 2009 will continue to be filed and settled using data from the Legacy PS&R. The PS&R Redesign will only contain the data needed to file January 31, 2009 cost reports, and later. All data needed prior to that period must continue to be requested from the MAC.
Note – information included on this webpage applies to the PS&R Redesign only. Any information pertaining to the Legacy PS&R will continue to be found in the Medicare Financial Management Manual (CMS Pub. 100-06) Chapter 9, and providers will continue to contact their MAC for more information.
There are numerous reports that may be generated from the PS&R, but they are primarily grouped into two categories, Provider Summary Reports and Payment Reconciliation Reports. Provider Summary Reports contain accumulated data that can be used for cost reporting and data analysis, summarized by specific criteria. The Payment Reconciliation Reports (also known as Detail Reports) contain detailed, claim specific data that supports the Provider Summary reports.
Users may generate their own Provider Summary reports using the PS&R Redesign user interface screens. The reports are available to be printed or downloaded using various methods. The Payment Reconciliation reports may be requested by the provider using the user interface screens, but due to the sensitive data they contain, the reports must be authorized and transmitted to the provider by their MAC.
Prior to accessing the PS&R system, users will first need to register for a user ID and password in CMS' Enterprise Identity Management system (EIDM). EIDM is the CMS identification and authentication system used to access CMS web-based applications. EIDM allows users to obtain one ID and password needed to access multiple web-based systems, one of which is the PS&R system. Links to the EIDM user guides and other helpful EIDM information are located on this page.