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Cost Report

Topic Brief Description

Mail and Contact Information

Noridian contact and mail information

Amendment or Reopening

Information to assist providers with submission of a Reopening or amended Cost Report

CMS Approved Cost Report Vendor Listing

Listing of all approved vendors that we can accept cost reports on

FFY 2004 and Earlier SSI Elections Instructions for providers submitting SSI elections in accordance with CMS Ruling 1498-R2.

Identify/Locate Provider

Provider Identification information showing which providers are associated with what cost reports

Low / No Utilization

Information to assist providers in filing a No/Low Cost Report

Provider Statistical and Reimbursement (PS&R) System

Information to help providers request a PS&R from Individuals Authorized Access to CMS Computer Systems (IACS) or how to resolve IACS issues

Swing Bed Days

Information to assist in reporting Swing Bed days on a cost report

 

Cost Report Form

The CMS Forms List This link takes you to an external website. webpage will display and provide an option to "Filter on" a term or phrase; enter the term "cost report" to obtain the applicable Cost Report form(s).

Elements Required in a Cost Report

  • Readable disk containing the Electronic Cost Report (ECR) utilizing a CMS-approved vendor.
  • Certification Page (Worksheet S) with original signature of an authorized official
  • The Settlement Summary amounts on Worksheet S match the Settlement Summary produced from the ECR
  • Include a check payable to Noridian if the cost report indicates an amount due to Medicare.
  • ECR and PI Files with matching Encryption Codes to Worksheet S
  • ECR passes all level 1 edits
  • Readable disk containing the Intern and Resident Information System (IRIS) that passes all edits for Teaching Hospitals
  • Form CMS-339 with original signature of an authorized official. This is not applicable for 2552-10, 2540-10, and 265-11 forms

Additional information to include with the cost report:

  • Trial Balance and Financial Statements
  • Provider Statistical & Reimbursement (PS&R) Report

If the submitted cost report is considered unacceptable, Noridian returns the cost report to the provider with a letter explaining the reasons for rejection. If the due date for the cost report has expired, Noridian will institute withholding of the interim payments and/or assessment of interest and penalties and issue a demand letter as soon as possible but no later than 30 days after the due date of the cost report. This payment suspension would remain until Noridian receives an acceptable cost report.

The following is a list of examples, if omitted, that could cause your cost report to be rejected. Please review this list before submitting your Medicare Cost Report:

  1. Use a CMS approved vendor with current specifications and updates.
  2. Use the correct PTAN. This includes the parent number and all subunits (i.e., HHA, Hospice, FQHC, RHC, SNF, and ESRD).
  3. Use the correct fiscal year beginning and end dates.
  4. Clear all Level 1 edits on the Electronic Cost Report (ECR).
  5. Submit an ECR file of the cost report.
  6. Submit a Print Image (PI) file of the cost report.
  7. Ensure an authorized official of the provider signs Worksheet S. Medicare requires providers submit the Worksheet S with an original signature.
  8. Ensure the encryption codes on Worksheet S match with those on the ECR and PI files. Reminder: Each time the cost report is accessed or updated by the provider, the encryption codes will change.
  9. Teaching hospitals must submit a complete and accurate Intern and Resident Information System (IRIS) diskette.
  10. Verify the settlement amounts on the ECR match the signed Worksheet S.
  11. Ensure an authorized official of the provider signs the CMS 339. Medicare requires providers submit the CMS 339 with an original signature, when applicable.
  12. Answer the Medicare Utilization question correctly (Blank indicates Full Medicare Utilization, N indicates No Medicare Utilization, and L indicates Low Medicare Utilization)
  13. Use valid cost center codes.

Cost Report Due Dates and Timelines

  1. Cost reports are due on or before the last day of the fifth month following the close of the cost reporting period (fiscal year end).
  2. No extensions will be granted except when provider's operations are significantly adversely affected due to extraordinary circumstances over which the provider has no control. An example would be a flood or fire that forces a provider to cease operations and to transfer its patients temporarily to other providers outside of the impacted area. The intermediary would still be required to obtain CMS approval.
  3. If the provider is unable to obtain access to the PS&R system, or cannot obtain their PS&R reports, and they contact their contractor for assistance, the contractor shall instruct the provider how to obtain their reports. The contractor may assist the provider by supplying them with the needed reports. Note that failure by the provider to contact the contractor in a timely manner does not warrant an automatic extension of the cost report due dates and could result in the provider's inability to file the cost report timely and thus be subjected to payment suspension.
  4. A cost report is considered timely filed if the cost report is postmarked by the due date. This requirement applies regardless of whether the provider furnishes a hard copy or a diskette version. If a cost report is due on a Saturday, Sunday, or Federal holiday, the cost report is considered timely filed if postmarked by the following working day.

Termination of Medicare Provider Agreement or Change in Ownership

  1. Cost reports are due no later than 5 months following the effective date of the termination of the provider agreement or the change of ownership.
  2. Items 2 through 4 in subsection A will apply.

Noridian Processing Timeline for Cost Reports

  • Acceptance of the cost report will be completed within 30 days from the date of receipt of the provider's cost report.
  • A tentative settlement will be completed within 60 days from the acceptance date.
  • In addition to the tentative settlement, a midyear lump sum may be completed to ensure all payments are an accurate reflection of the current rates.
  • If the file is selected for a limited or full review without an audit, the cost report will be finalized within 12 months of acceptance.
  • If the file is selected for a limited or full review with an audit, the cost report will be finalized within 60 days from the final exit conference.
  • Within 90 days before the next fiscal year end, a year end review and lump sum review may be completed.

Obtaining a Copy of a Cost Report

The CMS collects data from cost reports in the Healthcare Cost Reporting Information System (HCRIS). They are made available to the public on their website at https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/Cost-Reports/index.html This link takes you to an external website. .

Cost reports are also available through the Freedom of Information Act (FOIA). A request for a Medicare cost report should include the facility name; Medicare provider number, if known (if not known, the state the facility operates in), and the year-end of the cost report being requested. Also, the request should indicate whether an "as-filed" cost report or the "finalized" cost report (if available) is being requested. Requests may also be narrowed to only specific worksheets from a cost report.

A FOIA request for cost reports or other provider audit and reimbursement records may be submitted using the interactive Freedom of Information Act Request Form [PDF].

Resources:

Last Updated Jan 18, 2017