Program for Evaluating Payment Patterns Electronic Report (PEPPER)
Summarizes the Medicare claims data statistics for one provider in areas (target areas) that may be at risk for improper Medicare payments.
These target areas were selected by CMS because a national analysis of payment errors identified that they were high in either dollars in error or proportion of payment in error.
PEPPER can be used to review three years of data statistics for each of the CMS target areas, comparing performance to that of other hospitals or facilities in the nation, same specific Medicare Administrative Contractor (MAC) jurisdiction and/or state. PEPPER can also be used to:
Compare data statistics over time to identify changes in billing practices
Pinpoint areas in need of auditing and monitoring
Identify potential DRG under- or over-coding problems
Identify target areas where length of stay is increasing
PEPPER can help hospitals and facilities achieve CMS’s goal of reducing and preventing improper payments.
What do I use the PEPPER for?
Access tables and graphs displaying billing activity over time in comparison with other hospitals or facilities
Review hospital- or facility-specific data and comparative target area statistics for the state, jurisdiction, and nation
Track and trend administrative data statistics to identify changes in billing practices and Medicare reimbursement for CMS target areas