Provider statistical & reimbursement (PS&R) reports are generated by a standard system provided by the Centers for Medicare & Medicaid Services (CMS). The PS&R system accumulates Medicare Part A claims data processed on the standard claims processing system (i.e., Fiscal Intermediary Shared System [FISS]). The two primary reports produced by the PS&R system are The Provider Summary Report, and the Payment Reconciliation Report.
The Provider Summary Report is used by providers when preparing their Medicare cost report, and includes the following information for each provider for a specified period of time:
- Medicare Part A charges
- Medicare patient days
- Deductibles
- Coinsurance
- Payments, etc.
The Payment Reconciliation Report provides detailed claim data that supports the Provider Summary Report.
Requesting PS&R Reports
Providers in Illinois, Indiana, Kentucky, and Ohio should complete the National Government Services PS&R Extract Order Form  to request a PS&R report.
Attention Providers in Connecticut, Delaware, and New York
Transitional Outpatient Payments on the PS&R Report
The 15-month PS&R reports that are available on the Web site for purposes of filing cost reports show the correct amount of transitional outpatient payments (TOPS) for the year on the Reimbursement Report (i.e., the last two pages of the PS&R). However, when the Medicare Audit and Reimbursement Department generates more current PS&Rs during the settlement process, the TOPS payment amount showing on the Reimbursement Report may be incorrect. At settlement time, the payments that are made each month are pulled. The sum of these monthly payments for the year is applied as interim payments to the cost report. The monthly payments can be found on the remittance advice for the last day of each month. Please be aware of this discrepancy. The amount you see on the PS&R Reimbursement Report generated by National Government Services for a settlement may not coincide with the adjustment made to the interim payments for TOPS.
Please contact the Medicare Audit and Reimbursement office servicing your facility with questions.
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