Logo
ISO 9001:2000
Menu Arrow
Menu Top
Menu Arrow
Menu Top
Menu Arrow
ISO Certified

Hospital Inpatient Prospective Payment System (PPS) Medicare Payment Calculator

We are pleased to announce that National Government Services, Inc. Audit and Reimbursement department has developed an Excel spreadsheet to assist providers in calculating Hospital Inpatient PPS Medicare payments. This spreadsheet requires a list of provider specific fields to be entered, and consequently calculates the Medicare payment. It contains all of the factors and federal amounts that were included on the Provider Disclosure Statement (PDS). We hope that this spreadsheet will aid your analysis of Medicare payment, as well as supply the formulas that calculate the fields located on the PDS.

We expect to update the spreadsheet each time the Centers for Medicare and Medicaid Services (CMS) revises the PRICER program, usually on an annual basis in October.

If after completing the spreadsheet you are still not tying out to the claim payment:

  1. Ensure that all fields on the Input tab were entered correctly.
  2. Verify that the rates you entered are those that were in place on the date the claim was priced.
  3. If you are still having difficulty, please email your completed version of the Excel file to psandr@empireblue.com. Please include your name, provider number, telephone number and fax number in the email. Please provide any additional information that might assist us in our review, for example, which component(s) or Tab(s) are off.

Payment Calculation FY 2005 Excel File
Payment Calculation FY 2006 Excel File
Payment Calculation FY 2007 Excel File
Payment Calculation FY 2008 Excel File

Page Last Modified: 11/14/07

Note External Link: Links with this graphic go to an external site outside of Empire Medicare Services and will open in a new window.

Note PDF File: You must have the Adobe Acrobat Reader (version 4.0 or higher) to view the PDF files. If you do not already have this software,  you can Download it here (This software is free!).

Note Excel Spreadsheet File: Some of the files on this page are available only in Microsoft Excel format. If you cannot view Excel spreadsheets, download the Excel Viewer.

 

   
 
Spacer Image
 Translate this page >> 
 
 
 
 
 
 
 
 
 
 
Copyright