CMS is taking measures to free up the attention of providers as they respond to the coronavirus (COVID-19) pandemic. To this end, the planned April 6, 2020, release of the Q4FY19 PEPPERs for CAHs, LTACHs, IPFs, IRFs, hospices, and SNFs has been delayed. As more information becomes available, the PEPPER Team will notify providers about the rescheduled release date for the Q4FY19 PEPPERs. Join our email list to receive updates regarding PEPPER distribution.

Training & Resources for Critical Access Hospitals

Critical Access Hospitals PEPPER will be available via PEPPER Resources Portal at

Notice: Change in CAH PEPPER Delivery Method
At the request of the Centers for Medicare & Medicaid Services (CMS), beginning with the Critical Access Hospital (CAH) Program for Evaluating Payment Patterns Electronic Report (PEPPER) version Q4FY18, released April 5, 2019, the CAH PEPPERs are available for access through a secure portal at Previously the CAH PEPPERs were uploaded to QualityNet Administrators and those who have basic user accounts with the PEPPER recipient role. An email with instructions for accessing the CAH PEPPER was sent to CAH QualityNet Administrators April 5.

To download or save to your computer any of the files on this page, right click on the file name (link) and select "Save Target As...". To receive updates on training and other resources, please join our email list.

Current PEPPER User's Guide:


  • View a list of the 12 MAC jurisdictions and the number of providers in each jurisdiction in total and by state for PEPPER Q4FY18 (XLS, updated 3/28/2019).


Demonstration PEPPER:

  • Demonstration PEPPER version Q4FY18 (XLS, updated 3/28/2019)

Other Resources: