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

Automate Medicare Pricing

Empowering Payers and TPAs: How Automated Medicare Pricing Redefines Efficiency

By pwsadmin | September 2, 2025

Medicare claims processing can be a complex and time-consuming gauntlet. For professionals at Payers, PPOs, TPAs, BPOs, Self-Funded Employers, and Auditing Firms, navigating the ever-shifting landscape of CMS policies and pricing can feel like a full-time job in itself. The challenge isn’t just about getting the numbers right; it’s about doing so efficiently, securely, and…

Medicare Contract Claims

Finally, a Solution for Complex Contract Claims: The CMSPricer Contract Manager

By pwsadmin | August 28, 2025

For Payers, PPOs, TPAs, BPOs, Self-Funded Employers, and Auditing Firms, the task of pricing claims at specific, predetermined rates has long been a source of administrative headache. You’re not just dealing with Medicare’s complex fee schedules; you’re also juggling multiple, unique contracts, each with its own set of rules, provider networks, and rate increases. The…

Automated medicare claims repricing

How Automated Medicare Claims Repricing Can Improve Your Payer Efficiency

By pwsadmin | August 9, 2025

Medicare claims repricing can be a major pain point for many organizations, especially when handled manually. Payers, PPOs, TPAs, BPOs, Self-Funded Employers, and Auditing Firms often struggle with inefficient, outdated processes that lead to unnecessary errors, delays, and financial losses. The biggest challenge is the manual handling of Medicare pricing and contract management, which leaves…