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Written by: Darlene D'Altorio-Jones (1959-2015) on Thursday, May 30, 2013 Posted in: Inpatient Rehab

Late last fall, CMS posted this comment on their website, “Please be advised that CMS anticipates delays for all of the FY 2013 PC  Pricer releases (IPPS, IRF, IPF, LTCH, SNF, ESRD and HH). 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 April 1 and May 31, 2013.”

Here is what was released in late April:

Posted on April 22, 2013, is the anticipated files and information is now available.

Why a change? Fujitsu NetCOBOL is now required to run the pricer files. “A one-time installation of ‘Fujitsu NetCOBOL’ run time files is required. Instructions for downloading Fujitsu NetCOBOL run time files can be found in section one of the “PC Pricer Download Instructions.”  These instructions may be downloaded through the following link: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PCPricer/Downloads/Updated-PCPricer-Download-Instructions.pdf.

Question:  What are PC Pricer files?

Answer: The PC Pricer is a tool used to estimate Medicare PPS payments. The PC Pricer contains a provider file with records listing all Medicare  providers at the start of the quarter in which the particular version of PC Pricer was released. Facilities that have recently received their Medicare  provider number or had a change of ownership may not be included in the provider  file. If you can’t locate a provider number in PC Pricer it does not mean your  claims aren’t being paid.

Quarterly schedule:

For a given fiscal year, the PRICER release schedule is as follows:

  • First quarter release — On or about October 15
  • Second quarter release — On or about January 15
  • Third quarter release — On or about April 15
  • Fourth quarter release — On or about July 15

Questions regarding pricers can be directed to:  PCPricers@cms.hhs.gov.

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