Cost Reports

Access the below related information from this webpage.

Cost Report Form

  • See CMS Forms List webpage as it displays and provides an option to "Filter on" a term or phrase; enter term "cost report" to obtain applicable Cost Report form(s)

Cost Report Required Elements

  • Readable disk containing the Electronic Cost Report (ECR) using a CMS-approved vendor
  • Certification Page (Worksheet S) with original signature of an authorized official
  • The Settlement Summary amounts on Worksheet S match Settlement Summary produced from ECR
  • Include a check payable to Noridian if 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 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 cost report:

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

If a submitted cost report is considered unacceptable, Noridian (we) will return it to the provider with a letter detailing the reasons for rejection. If the cost report due date has expired, we 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 its due date. This payment suspension will remain until we receive an acceptable cost report.

View below list of example before submitting Medicare Cost Reports. If omitted, cost report may be rejected.

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

Cost Report Due Dates and Timelines

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

Medicare Provider Agreement or Change in Ownership Termination

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

Cost Report Processing Timelines

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

Obtain 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 the CMS Cost Reports webpage.

Cost reports are also available through the Freedom of Information Act (FOIA). A request for a Medicare cost report should include:

  • Facility name
  • Medicare provider number, if known (if not known, state facility operates in)
  • Year-end of cost report being requested

Request should also indicate whether an "as-filed" cost report or the "finalized" cost report (if available) is being requested and can 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 via the Freedom of Information Act Request Form.

Resources

Last Updated Jul 18, 2018