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PC Pricer: Pricer Cobol Code Text Files

Guidance for Pricer Cobol text files including: ESRD PPS Pricer Code, FQHC PPS Pricer Code, Home Health PPS Pricer Code, Hospice PPS Pricer Code, Inpatient PPS Pricer Code, Inpatient Psychiatric PPS Pricer Code, Inpatient Rehabilitation PPS Pricer Code, Long Term Care PPS Pricer Code, OPPS PPS Pricer Code, and Skilled Nursing Facilities PPS Pricer Code.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 01, 2020

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As part of ongoing efforts to modernize Medicare payment systems, CMS has converted all 10 Pricer applications from the COBOL programming language to the Java programming language. As of January 2022, CMS no longer posts COBOL source code. CMS now only posts Java source code (for reference) and software (executable).

CMS posts Pricer source code to fulfill Freedom of Information Act (FOIA) requests, and facilitate Medicare pricing methodology and rate transparency. Therefore, CMS only posts Pricer source code and data files that contain pricing methodology and rates, respectively. CMS started posting Java Pricer source code in the first quarter of 2021.  CMS does not provide technical support to incorporate Pricer source code and software into new or existing systems outside of its Original Medicare claims processing system.

Java Source Code vs. Software – Which will meet your needs?

  • The Java Source Code (JAR files) is for users that are interested in seeing the Pricer’s calculations and rates. The source code cannot be compiled or executed as-is. Any es in the 'gov.cms.fiss.pricers.common' package or its sub-packages (provided via the 'pricer-common-*' dependencies) are not included. The excluded es do not contain pricing methodology or rates.
  • The Software (Executable JARs) is for users that want to execute the Pricer software to price claims.

Date of First Java-only Pricer Release and Years Supported by the JAR Files

  • End-Stage Renal Disease (ESRD) PPS – January 2022; CY 2020 and later
  • Federally Qualified Health Center (FQHC) PPS - January 2022; CY 2019 and later
  • Home Health (HH) PPS – January 2022; CY 2020 and later 
  • Hospice PPS – January 2022; FY 2020 and later
  • Inpatient PPS (IPPS) - October 2021; FY 2019 and later
  • Inpatient Psychiatric Facility (IPF) PPS – January 2022; FY 2020 and later
  • Inpatient Rehabilitation Facility (IRF) PPS - October 2021; FY 2015 and later
  • Long Term Care Hospital (LTCH) PPS - October 2021; FY 2020 and later
  • Outpatient PPS (OPPS) - January 2022; CY 2020 and later
  • Skilled Nursing Facility (SNF) PPS - January 2022; FY 2020 and later

Software (Executable JAR Files)

Java Source Code (JAR Files)

COBOL Source Code (Text Files)

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.