Handle a Special Filing Situation - JE Part A
Handle a Special Filing Situation
Most providers submit a standard annual Medicare Cost Report. However, certain situations may require additional reporting, documentation, or approval.
Use the information below to understand common special filing situations and the requirements that may apply.
Request a Cost Report Extension
Medicare Cost Report extensions are granted only under extraordinary circumstances that significantly disrupt a provider's operations and are beyond the provider's control. Examples may include natural disasters, significant facility emergencies, and other CMS-approved circumstances.
CMS approval is required before an extension can be granted.
How to Request an Extension
To request an extension:
- Complete the Cost Report Extension Request Form, available on our Audit and Reimbursement Forms page. The completed form should be emailed to: costreportextension@noridian.com
- Submit the request before the filing deadline.
- Ensure the request is signed by an Authorized Official or Administrator listed in the provider's Medicare enrollment record or currently listed in the System for Tracking Audit and Reimbursement (STAR).
Is your STAR Contact information outdated? Submit a STAR Contact Change Form (on the Audit and Reimbursement Forms page) before requesting certain reimbursement services to help avoid processing delays.
Extension requests should be submitted as soon as possible when circumstances arise that may affect your ability to file on time.
Low/No Medicare Utilization
No Medicare Utilization
Providers that did not furnish any covered services to Medicare beneficiaries during the entire cost reporting period are not required to file a full cost report. Instead, they must submit:
- A signed statement from an authorized official that:
- Identifies the applicable reporting period
- Confirms that no covered services were provided
- States that no Medicare claims will be submitted for that period
- A completed certification page from the applicable cost report form
This documentation must be submitted to Noridian within 150 days after the end of the reporting period.
Low Medicare Utilization
Providers with low Medicare utilization and low interim reimbursement payments may qualify to submit a reduced cost report.
Reimbursement Thresholds
| Provider Type | Reimbursement Threshold |
|---|---|
| Hospital | $200,000 |
| Skilled Nursing Facility (SNF) | $200,000 |
| Rural Health Clinic (RHC)/Federally Qualified Health Clinic (FQHC) | $50,000 |
Important Considerations
- Total reimbursement includes interim payments (from Provider Statistical & Reimbursement (PS&R) System)), bi-weekly payments (including Periodic Interim Payments (PIP)), and lump sum adjustments.
- Thresholds apply to the entire provider complex. For example, a hospital with a provider-based FQHC must meet the $200,000 hospital threshold, not a combined $250,000.
- Providers with short-period cost reports must annualize their reimbursement to determine eligibility.
- Providers filing under low utilization cannot claim Medicare bad debts. If bad debts are being claimed, a full cost report is required
- Low/No utilization reports must be submitted within the same timeframe as full cost reports.
- If Noridian later determines that the criteria were not met, or that a full report is needed in the best interest of the program, a full cost report will be required.
Required Forms for Low Utilization Reports
All submissions must include:
- Signed Officer Certification Sheet with applicable Worksheet S pages
- Balance Sheet
- Income and Expense Statement (Worksheet G series may be used)
Additional worksheets vary by provider type:
Hospitals (Form CMS 2552-10):
- Worksheet S-2
- Worksheet S-3
- Worksheet E Series
Skilled Nursing Facilities (Form CMS 2540-10):
- Worksheet S-3
- Worksheet E Series
FQHCs and RHCs (Forms CMS-224-14 and 222-17):
- Worksheet S, Parts I-III
- Worksheet C, Parts I-II
Fiscal Year End Changes
Providers requesting a Fiscal Year End (FYE) change must follow applicable CMS requirements and ensure reporting periods are adjusted appropriately.
Changing a fiscal year end may affect:
- Cost report due dates
- Reporting periods
- Reimbursement calculations
- Settlement processing timelines
Learn More About Fiscal Year End Changes
Amended Cost Reports and S-10 Revisions
Providers may need to amend a previously submitted cost report or revise Worksheet S-10 information after filing.
Requirements vary depending on:
- The reason for the amendment
- The reporting period involved
- The status of the original cost report
Before submitting amended information, review the applicable guidance to determine what documentation and approvals may be required.
Learn More About Amended Cost Reports and S-10 Revisions
Change of Ownership (CHOW)
A Change of Ownership (CHOW) may create additional cost reporting requirements and filing deadlines.
Providers experiencing a CHOW may be required to submit:
- A terminating cost report
- Additional supporting documentation
- Information related to ownership transfer and reporting periods
Because filing requirements vary, providers should review applicable guidance as soon as a change of ownership occurs.
Medicare Provider Agreement Terminations
When a Medicare Provider Agreement terminates, special filing requirements apply.
Cost reports associated with provider agreement terminations are generally due no later than five months following the effective termination date.
Providers should review applicable requirements promptly to avoid filing delays or compliance issues.
Additional Resources
The following resources may also be helpful when dealing with special filing circumstances:
- Fiscal Year End Changes
- Amended Cost Reports and S-10 Revisions
- Medicare Cost Report e-Filing (MCReF)
