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Self Service Medicare and Medicaid Solutions Repricing Made Easy

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

Why CMSPricer to re-price your Medicare and Medicaid 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.


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.


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. 


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





Why our clients value us:

“CMSPricer meets our stringent CMS Medicare claims accuracy requirements for auditing claims from over 50 Medicare Advantage plans. Using the CMSPricer SaaS based tool and interface allows us to effectively batch process with ease and precision. Great partner!”  


Our latest blog update

Top Secrets to Making Reference Based Pricing Work in the Covid-19 World

By pwsadmin | September 25, 2020

The US spends $ 3.6tn a year on health. Post Covid-19 times, this spending is breaking all previous records and people are really concerned about high out-of-pocket costs.  In times of the Covid-19 pandemic, healthcare experts anticipate healthcare costs will continue to rise. In April 2020, a health report estimated that $163.4 billion in direct…

What are the Benefits of Using a SaaS-based Medicare Repricing Solution and Their Impacts?

By pwsadmin | September 18, 2020

Every Medicare repricing solution might be different, but almost every single one makes the same mistake by putting the company in jeopardy: it delays in complying with the CMS updates.  As a result of delayed CMS update compliance: Inaccurate payment or overpayment risks Claims re-working or readjusting Strained provider relations or increased provider inquiries Holding…

Best Ways to Meet Payer’s Cost-Containment Goals and Protect Bottom-line During the COVID Crisis

By pwsadmin | August 22, 2020

In order to navigate the healthcare crisis and economic turmoil resulting from the coronavirus outbreak, many organizations are recalibrating their employee healthcare benefit programs. They are now more focused on finding solutions to keep their team members safe and healthy.  Yes, it is also true that many organizations across the country are being compelled to…