Medicare Pricing and Contract Management Solutions Made Easy

Most Accurate, Highly Secure and Lowest Cost Solutions on the Market

Why use CMSPricer to re-price and edit your Medicare claims?

No Set Up

Web-based with results returned in seconds priced at 100% of Medicare rates. Hand Key Entry or Auto Batch/EDI Uploads, Easy imports/exports. 

No Hassle

No contracts, No sales people…..pre-pay purchase with volume discounting and easy online payment processing.

Accurate

Frequent engine updates with latest CMS policies and rates to ensure accurate claims pricing. The CMS.Gov typically has a 3 month lag time and incomplete pricing results. We price all PPS types of Institutional and Professional claims including claim editing for Referenced Based pricing.

Security

No PHI or claims data stored. Utilizes contemporary cloud-based security, including EV SSL Certificate, 5HA2, and 2048 bit encryption (strongest on the market). Fully HIPAA and ANSI 837 version 5010 compliant. Every user has their secure login and account. 

Availability

As long as you have access to the Internet, you can run 24/7/365 securely *excluding short windows for system maintenance.

Our Clients

We serve Payers, PPOs, TPA’s, BPO’s, Self-Funded Employers and Auditing Firms.

New Users 5 Claims FREE no commitments

NO SOFTWARE TO INSTALL

NO COMPLEX CONTRACT TO SIGN

USA OWNED AND OPERATED

100% ON-SHORE RESOURCES

ACCURATE SaaS CLAIMS PROCESSING

EASY MANUAL, BATCH OR API Claims Integration Claims ENTRY

Why our clients value us:

Our latest blog update

Medicare repricing software

Slash Denials and Capture Revenue: Achieve 98% Clean Claim Rates Instantly

By pwsadmin | November 19, 2025

In the relentless pursuit of a healthy revenue cycle, nothing is more frustrating and costly than claim denials. For organizations that handle vast volumes of claims, the difficulty is compounded by the constant complexity of coding, ever-shifting CMS rules, and regulatory updates, changes that can occur daily. The traditional approach of manually chasing down these…

Medicare Pricer Software

Integrating for Impact: How CMSPricer Contract Manager Transforms Your Claims Workflow

By pwsadmin | October 31, 2025

That’s a fantastic question. The real power of any SaaS Medicare repricing software isn’t just in its features, but in how seamlessly it integrates into your existing, complex operations. For Payers, TPAs, Auditing Firms, and Self-Funded Employers, integration is the key to unlocking the promised 3X acceleration. CMSPricer’s design, including the powerful Contract Manager Claims…

Batch Claims Processing API

Why Forward-Thinking Payers and TPAs Are Turning to CMSPricer’s Batch Claims Processing API to Transform Repricing

By pwsadmin | October 17, 2025

In healthcare, time isn’t just money, it’s compliance, accuracy, and ultimately, trust. Every payer, PPO, TPA, BPO, self-funded employer, and auditing firm knows the pressure of processing Medicare claims quickly while navigating a maze of CMS rules. The challenge? Traditional repricing methods simply can’t keep up with today’s claim volumes and regulatory complexity. This is…