Medicare PPS HIPPS Code Repricer


This conversion table is the tool that all cash posters MUST have! It allows a recalculation of Medicare payments under Medicare PPS Reform based on the 18-digit OASIS Matching Key. Agencies will be able to verify that the amount paid on the Final Claim is the correct payment based on the recalculation method outlined in the Final PPS Refinement Regulation. It also includes calculating LUPAs. Immediately available for download!

 The HPS Medicare PPS HIPPS Code Repricer has been updated for 2019!


 Please note that if you have an episode that began in 2018 and ended with a billable visit in 2019, due to the change in the treatment authorization algorithm, there will be claims where the functional status shows as changed in the HIPPS Code Repricer that are not changed in the Medicare MAC system. Please email me at with specific issues or questions regarding this.