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 RURAL Add-On was reinstated and was made retroactive to January 1, 2018 and the updated RePricer takes this into account.

Please note that if you have an episode that began in 2017 and ended in 2018 and does NOT require recalculation of the HIPPS code due to a change in therapy or early vs late there may be an issue with the total calculation of the reimbursement in the repricer.  Due to the change in the algorithm of the treatment authorization code from 2017 to 2018 the repricer is only accurate for these crossover claims if the code needs repricing.  Please email me at with issues.  There should be NO issues with episodes that begin January 1, 2018 and later. 

Lastly, if you are in a Value Based Purchasing State you will need to ensure that you follow guidance for #7 on the instruction page.