Program for Evaluating Payment Patterns Electronic Report

The RELI Group, along with its partners TMF Health Quality Institute and CGS, is contracted with the Centers for Medicare & Medicaid Services (CMS) to develop, produce and disseminate provider-specific comparative data reports, referred to as the Program for Evaluating Payment Patterns Electronic Report, or PEPPER. PEPPER summarizes one provider’s Medicare claims data statistics for areas that have been identified by CMS as at higher risk for improper Medicare payments due to billing, coding, and / or admission necessity issues.

PEPPER is available for the following provider types:

  • Short-term acute care hospitals (developed in 2002),
  • Long-term acute care hospitals (developed in 2005),
  • Critical access hospitals, inpatient psychiatric facilities and inpatient rehabilitation facilities (developed in 2011),
  • Hospices and partial hospitalization programs (developed in 2012),
  • Skilled nursing facilities (developed in 2013), and
  • Home health agencies (developed in 2015).

We would like to encourage providers to access these free comparative billing reports and utilize them as tools to support their auditing and monitoring efforts. Please review this notice on the changes in distribution process for Critical Access Hospitals (CAHs) from QualityNet to PEPPER portal access, effective with the Q4FY18 version on April 5, 2019. The CAH PEPPERs are now available at https://pepper.cbrpepper.org/ via a secure portal. If you need validation codes to access the PEPPERs, please contact the PEPPER Help Desk.

Visit https://pepper.cbrpepper.org/  for sample PEPPERs, user’s guides, recorded training sessions and national-level comparative data. The PEPPER distribution schedule and more information on how to get your organization’s PEPPERs can also be reviewed.