Have You Accessed Your PEPPER Report?

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

The PEPPER Team has updated the maps that display the PEPPER retrieval rates for PEPPERs accessed via the PEPPER Resources Portal for each state/territory. Percentages reflect the PEPPER release that was completed July 29, 2020, for skilled nursing facilities (SNFs), critical access hospitals (CAHs), hospices, and long-term acute care hospitals (LTCHs) and that was completed Aug. 12, 2020, for home health agencies (HHAs).

Please click on a link below to view the maps. Click on a state to obtain details, such as the number of PEPPERs available in the state via the portal, the number of PEPPERs accessed via the portal, the retrieval rates, and a link to the data file for all states/territories in the nation. The maps are updated monthly.

Map of Q4CY19 HHA PEPPER retrievals by state 

Map of Q4FY19 SNF PEPPER retrievals by state

Map of Q4FY19 Hospice PEPPER retrievals by state

Map of Q4FY19 LT PEPPER retrievals by state

Map of Q4FY19 CAH PEPPER retrievals by state

PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities.  Visit PEPPER.cbrpepper.org to access resources for using PEPPER, including user’s guides, recorded web-based training sessions, and a sample PEPPER. PEPPER is developed under contract with the Centers for Medicare & Medicaid Services (CMS) by RELI Group, along with its partners TMF® Health Quality Institute and CGS.

Have you accessed your PEPPER? If not, you can boost your state’s rates:

  1. Visit the “Distribution Schedule – Get Your PEPPER page” at PEPPER.cbrpepper.org.
  2. Review the instructions and obtain the information required to authenticate access. Note: A new validation code will be required. A patient control number or medical record number from a claim for a traditional Medicare Fee-for-Service beneficiary with a “from” or “through” date in July 1 – Sept. 30, 2019, (Oct. 1 – Dec. 31, 2019, for HHAs) will be required.
  3. Access the PEPPER Resources Portal.
  4. Complete all the fields.
  5. Download your PEPPER.