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

Healthcare contract configuration software

End the 3-Month Lag: How CMSPricer Delivers 100% Accurate Medicare Rates in Seconds to Save Your Firm Millions

By pwsadmin | December 21, 2025

Speed and accuracy are essential requirements that impact your bottom line in health claim processing. If you’re a Payer, TPA, Auditing Firm, or Self-Funded Employer involved in reference-based pricing, you understand the frustration of relying on outdated and incomplete Medicare data. This delay leads to costly errors, time-consuming rework, and capital tied up in misvalued…

Healthcare contract configuration software

Beyond Medicare: How CMSPricer’s Contract Manager Cuts Claims Processing Time by 3X and Guarantees Contract Accuracy

By pwsadmin | December 17, 2025

If you are already a user of our automated Medicare pricing and editing solution, you know the power of having accurate, up-to-the-minute CMS data at your fingertips. You’ve already eliminated the three-month pricing lag and reduced your reliance on manually verified fee schedules. But for Payers, PPOs, and large TPAs, the job doesn’t end with…

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…