DRG - PC Pricing - JE Part A

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.

View the CMS Web Pricers webpage for additional details.