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What is a Medicare Cost Report?

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29 Mar What is a Medicare Cost Report?

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A Medicare Cost Report is needed for your facility’s reimbursement. Medicare-certified providers are required to complete and submit a cost report on a yearly basis.

 

A Medicare Cost Report is a financial report that identifies the charges related to healthcare activities. Cost Reports are used to report expenses for different types of  Medicare reimbursable facilities, such as hospitals, Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs), Renal Dialysis Facilities, hospices, health clinics, Community Mental Health Centers (CMHC), Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs). Most Medicare-certified providers are required to complete and submit a cost report to Medicare Administrative Contractor (MAC) on a yearly basis. Filing delays may affect reimbursement.

The specific requirements for these reports are regulated by Centers for Medicare and Medicaid Services (CMS), the US government organization in charge of Medicare.

The cost report contains a variety of provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).

Cost report forms vary depending on facility type:

  • Hospital Cost Report (CMS-2552-96 and CMS-2552-10),
  • Skilled Nursing Facility Cost Report (CMS-2540-96 and CMS-2540-10),
  • Home Health Agency Cost Report (CMS-1728-94),
  • Renal Facility Cost Report (CMS-265-94 and CMS-265-11),
  • Health Clinic Cost Report (CMS-222-92),
  • Hospice Cost Report (CMS-1984-99 and CMS-1984-14),
  • Federally Qualified Health Clinic Cost Report (CMS-224-14),
  • Rural Health Center Cost Report (CMS-222-17), and
  • Community Mental Health Center Cost Report (CMS-2088-92 and CMS-2088-17).

Cost reports must be submitted in electronic format, known as Electronic Cost Reports or ECRs. Submission requirements include submitting the ECR files and the signed signature sheet. Supporting fiscal documentation is required, and may vary by Medicare Administrative Contractor.

Cost reports are due five months after the fiscal year end. If the books run January 1 - December 31, then Cost Report filing date every year is May 31 of the following year. If the due date is on a weekend or holiday - Cost Reports are due on the first workday afterwards. "due" means must be filed (either mailed or uploaded to MCReF) on or before the due date. Grace periods are provided for resubmission when filed cost reports need to be fixed. Filing extensions are granted only under extreme circumstances and penalty for overdue cost reports is withholding of payments, so file on time!

 

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