Certain institutional providers are required to file a Medicare cost report annually to CMS, which uses that information to set prospective payment rates and determine if Medicare overpaid or underpaid a given institution during the submitted fiscal year. 1 These reports are due to CMS 5 months after the institution’s fiscal year ends and include data such as facility characteristics, financial information, costs, and charges. 2 Cost report sections are separated as worksheets, with each containing distinct pieces of required information.
Full Answer
What is included in a Medicare Cost Report?
Most Medicare-certified providers are required to submit an annual cost report to CMS. The cost report contains 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.
What are the Medicare Cost Report public use files?
The Cost Report Public Use Files present select measures provided by Medicare providers through their annual cost report, and are organized at the provider level. Most Medicare-certified providers are required to submit an annual cost report to CMS. Medicare Provider Cost Report Public Use Files | CMS Skip to main content
What is the Medicare Cost Report electronic filing?
Medicare Cost Report Electronic Filing (MCReF) Each year, Medicare Part A providers must submit an acceptable Medicare Cost Report (MCR) package to their Medicare Administrative Contractor (MAC) for the purposes of determining their Medicare reimbursable cost. The MCR package consists of a variety of cost report materials.
How do I file a Medicare ECR report?
How to File Medicare Cost Reports Cost reports must be submitted in electronic format, known as Electronic Cost Reports or ECRs. They used to need to be submitted via floppy disk, CD, or flash drive only. Submission requirements include submitting the ECR files and the signed signature sheet.
What is Medicare cost report used for?
Medicare cost reports are used to report expenses for different types of Medicare reimbursable facilities, such as Skilled Nursing Homes (SNFs), Home Health Agencies (HHAs), Home Offices, Hospices, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Comprehensive Outpatient Rehabilitation ...
What is the CMS cost report?
The cost report contains 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).
How often are Medicare cost reports filed?
Each yearEach year, Medicare Part A providers must submit an acceptable Medicare Cost Report (MCR) package to their Medicare Administrative Contractor (MAC) for the purposes of determining their Medicare reimbursable cost.
What is the purpose of a cost report?
PURPOSE: To ensure that the filed cost report has been reviewed for accurate presentation of the facility's operations, compliance with applicable regulations, and adequate documentation to support the costs claimed.
What are the key elements of the Medicare cost report?
The cost report contains 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.
How do you do a cost report?
2:457:28Cost Report Basics - YouTubeYouTubeStart of suggested clipEnd of suggested clipIf the parent provider has sub-units make sure all sub-units are included in the cost. Report thisMoreIf the parent provider has sub-units make sure all sub-units are included in the cost. Report this includes any sub-units that have termed during the fiscal.
How are hospital costs calculated?
Hospital Charges are calculated by dividing the Operating Costs by the Cost-to-Charge Ratio.
What is cost report accounting?
A cost report will generally include all the costs incurred by the date of the report, where they are known, a forecast of the costs likely to be incurred during the rest of the project, in so far as these can be foreseen and estimated, and risk allowances for the possibility of unforeseeable costs.
What is meant by MCReF?
MCReF is the Medicare Cost Report e-Filing system. The portal allows Medicare Part A providers to electronically transmit (e-file) their cost report and supporting documentation directly to their respective Medicare Administrative Contractor (MAC).
How do you calculate cost analysis?
How to calculate cost analysisDetermine the reason you need a cost analysis. The way you use a cost analysis can vary depending on why you need a cost analysis done. ... Evaluate cost. ... Compare to previous projects. ... Define all stakeholders. ... List the potential benefits. ... Subtract the cost from the outcome. ... Interpret your results.
What is the purpose of a production report?
The purpose of this form is to keep track of a production's progress and expenses and to help determine what salary is owed to the cast and crew.
How do you prepare a production cost report?
(Steps Enumerated in the Production Report) 1: Analyze the physical flow of production units. 2: Calculate equivalent units for each manufacturing cost element. 3: Determine total costs for each manufacturing cost element. 4: Compute cost per equivalent unit for each manufacturing cost element.
What is a Medicare cost report?
Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC). The cost report contains 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.
How many zipped files are there in CMHC?
For the Hospice, Renal, Health Clinic and CMHC cost reports, there is one zipped file each that contains all data for all the fiscal years. The links to these can be found on their section pages.
Can a hospital cost report be loaded into Excel?
The Hospital and Skilled Nursing Facility cost report data cannot be loaded into Microsoft Excel. The numeric data file for these cost reports is too large for the application.
Is CMS accurate?
These reports are a true and accurate representation of the data on file at CMS. Authenticated information is only accurate as of the point in time of validation and verification. CMS is not responsible for data that is misrepresented, misinterpreted or altered in any way. Derived conclusions and analysis generated from this data are not to be considered attributable to CMS or HCRIS.
What is a hospital cost report?
The Hospital Cost Report Public Use File (Hospital Cost Report PUF) presents select measures provided by hospitals through their annual cost report, and is organized at the hospital level. The Hospital Cost Report PUF is available in a downloadable, user-friendly Excel format. The PUF does not contain all measures reported in the cost reports, but rather includes a subset of commonly used measures. Any hospital that submitted a cost report in a given year will be included in the PUF. For a full list of variables included in this PUF and their descriptions, please see the “Documentation” tab in the Excel file below.
What is a PUF report?
The Hospital Cost Report Public Use File (Hospital Cost Report PUF) presents select measures provided by hospitals through their annual cost report, and is organized at the hospital level. The Hospital Cost Report PUF is available in an interactive format or a downloadable CSV . The PUF does not contain all measures reported in the cost reports, but rather includes a subset of commonly used measures. Any hospital that submitted a cost report in a given year will be included in the PUF. For a full list of variables included in this PUF and their descriptions, please see the Data Dictionary .
Does PUF include all measures?
The PUF does not contain all measures reported in the cost reports, but rather includes a subset of commonly used measures. Any hospital that submitted a cost report in a given year will be included in the PUF. For a full list of variables included in this PUF and their descriptions, please see the “Documentation” tab in the Excel file below.
What is MCR in Medicare?
Each year, Medicare Part A providers must submit an acceptable Medicare Cost Report ( MCR) package to their Medicare Administrative Contractor (MAC) for the purposes of determining their Medicare reimbursable cost. The MCR package consists of a variety of cost report materials. The Medicare Cost Report e-Filing system (MCReF) provides all Medicare ...
What is MCR package?
The MCR package consists of a variety of cost report materials. The Medicare Cost Report e-Filing system (MCReF) provides all Medicare Part A providers the ability to electronically file 100% of their MCR package, including all supporting documentation, directly to their MAC for Fiscal Year Ends on or after 12/31/2017.
When are cost reports due for Medicare?
Cost reports are due five months after the fiscal year end. Any delays are subject to withholding of Medicare reimbursement. Facilities will try to use these cost reports to maximize legal reimbursement by ensuring correct filing and reporting of fiscal data. Facilities with low or no Medicare utilization need to submit a low-utilization cost ...
What is the final amount due to or from a facility on a Medicare cost report?
For facilities paid via PPS, there still may be reimbursement for bad debt or vaccines. The final amount due to or from the facility is called the settlement and shows up on the Worksheet S (the signature page) of the cost report.
What is CMS in Medicare?
Centers for Medicare and Medicaid Services (CMS), the United States government organization in charge of Medicare, regulates the specific requirements for these reports. [ 2] Medicare cost report software is strictly monitored to be CMS-compliant so that reports will be accurate and fulfill all requirements.
Why do cost report forms change?
The cost report forms often change to reflect changes to regulations, as evidenced by the changes brought by the aforementioned e-filing system. Major changes will result in new transmittals of the forms. [ 4] While the forms are downloadable from the CMS website (see list of forms below), the forms from the website cannot be used to actually complete the cost report, since they do not create the ECR files. [ 5]
What is hospice cost report?
The Hospice cost report measure s cost per patient day per level of care to the facility for each of Continuous Home Care, Routine Home Care, Inpatient Respite Care, and General Inpatient Care. It further determines Medicare and Medicaid costs to the facility for each level of care.
What is a home health agency cost report?
The Home Health Agency cost report measures cost per visit to the facility for each of Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Work, and Home Health Aides.
Can a cost report be electronically signed?
New cost reporting rules allow for cost report signature pages to be signed "electronically". This means that they may be signed on the software itself or signed and then scanned back into a computer as long as the " Electronic Signature " checkbox on the signature page is checked. If it is not checked, the original, signed signature page must be sent in hard copy format. [ 7]
What is a report file for a hospital?
Report file (Hosp10_2015_RPT): This file contains 1 record for each cost report and provides a description (e.g: Report fiscal year beginning/ending dates, Medicare Provider Number of the submitting hospital, etc.).
Where to find cost report form?
The cost report forms submitted by hospitals, as well as other provider types, can be found in the Provider Reimbursement Manual – Part 2. Note that each provider type submits a different cost report form, and for some provider types, the form has changed over time.
Where is the worksheet indicator on HOSP2010?
The worksheet indicators are found in the Downloads section on the Hospital Form 2552-10 page (i.e: in the zip file with the data model and data specifications documents). From the zipped file, click on the document titled, “HOSP2010_Worksheet Codes.” The worksheet indicator for Worksheet S-3, Part 1, is on Page 2 of the document (Figure 7). Worksheet S-3, Part 1, will be identified with the worksheet indicator “S300001.”
What is HCRIS_Data_Model?
The PDF document labelled “HCRIS_Data_model” contains all of the column names in the order they show up in the data files, as well as a schematic demonstrating how the files are linked together (Figure 4). The “RPT_REC_NUM : NUMBER (PK)” variable is an HCRIS-assigned Report Record Number variable used as the linking variable between each of these files. There is no facility identifier in the Alpha-numeric and Numeric files, so you will need to look up any facilities of interest in the Report File, identify the Report Record Number for the report (s) submitted by that facility, and look up that facility’s cost report data in the other files using their Report Record Number.
What is the line number in a cost report?
The Line and Column Numbers are 5 position codes in which the third position is the first position to the left of the decimal point. For instance, for Column 2, Line 14, “00200” would represent the column, and 01400 would represent the Line. Sometimes sub-columns exist in the cost reports (e.g: column 3.1). Column 3.1 would appear as “00310”.
What is the report record number?
We have already discussed the Report Record Number, which is used to link between the Alpha-numeric, Numeric, and Report Files. The Worksheet, Line, and Column Numbers refer to the position of the data element of interest within the Cost Reports submitted by hospitals. Therefore, in order to identify a specific variable in the files downloaded from the CMS website, the variable must be located within the forms submitted by Hospitals.
What does specification mean in cost report?
The specification also indicates which lines are reported for a given column and the field size. (Lines and columns not reported are represented by greyed-out boxes on the cost report forms.)
What is Medicare cost report?
And the Medicare cost report is probably the most comprehensive report of what’s going on in a hospital other than their own financial statements. And you have to file it annually. And you have to certify that everything in it is accurate. And it’s used to drive your payments going forward.
Why is it important to give everything in there accurately when you file your cost report?
So, giving everything in there accurately when you file your cost report, so that anything that is based off of rate setting, anything you need to pay based off rate setting and pass-through payments needs to be accurate because it could definitely have a financial impact on your current year financial statements.
Why is cost report important?
So, the cost report is definitely very important. Cost-to-charge ratios drive some of the Medicaid programs. And it does also drive some of the Medicare reimbursement as well. And don’t forget, it’s not just inpatient that’s impacted by the cost report, it’s also outpatient, rehab, SNP. Those payments are also computed on the Medicare cost report.
What is review of key reimbursement factors?
Review of key reimbursement factors are that are used to calculate the pass-through payments on a cost report
Does Medicare cost report include bad debt?
DeLicia: Yes , thanks. The Medicare cost report is used to calculate the IME, GME, Medicare bad debt, DSH pass-through payments. And failure to get the dollars on those cost reports accurately can definitely have an impact on your financials any upcoming year.
Does North Carolina have a cost report for Medicaid?
Now, as I say that, some states do make tweaks to how they want things reported for their Medicaid cost report reporting. I’ll give you an example. North Carolina is one of the states that you’ll have to do a few little tweaks within the cost report from your Medicare to your Medicaid to get the proper reimbursement.
Is Medicare bad debt?
And bad debt, Medicare bad debt, has always been around. Historically, years ago, they paid $.70 on the dollar. Now they pay $.65 on the dollar. But then it’s subject to sequestration. So that’s 2% that goes away. So it really ends up being $.63 on the dollar which you’ve got to make sure that you follow all the procedures—your bad debt logs are correct, that your Medicare bad debt policies and procedures are correct, so that you can truly get the dollars that you deserve.
HCRIS Data Disclaimer
The Centers for Medicare & Medicaid Services (CMS) has made a reasonable effort to ensure that the provided data/records/reports are up-to-date, accurate, complete, and comprehensive at the time of disclosure. This information reflects data as reported to the Healthcare Cost Report Information System (HCRIS).
General Information
Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC). The cost report contains 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.
Frequently Asked Questions
There is a document available at the bottom of this page, the HCRIS FAQ, which answers some questions about HCRIS, the data files, and the cost reporting process.
Technical Assistance
Free assistance to academic, government and non-profit researchers interested in using HCRIS data is available at : ResDAC, the Research Data Assistance Center.
Freedom of Information Act
Individual cost reports may be requested from the Medicare Administrative contractors via the Freedom of Information Act (FOIA). For more information on this process, visit the FOIA page.
HCRIS Data Disclaimer
General Information
- Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC). The cost report contains 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. ...
New Cost Report Data Available
- * Due to being replaced by newer forms and an absence of updates, the HOSPICE-1999, SNF-1996 and RNL-1994 data files will no longer be updated.
Frequently Asked Questions
- There is a document available at the bottom of this page, the HCRIS FAQ, which answers some questions about HCRIS, the data files, and the cost reporting process.
Technical Assistance
- Free assistance to academic, government and non-profit researchers interested in using HCRIS data is available at : ResDAC, the Research Data Assistance Center.
Freedom of Information Act
- Individual cost reports may be requested from the Medicare Administrative contractors via the Freedom of Information Act (FOIA). For more information on this process, visit the FOIApage. Organization of data files: For the Hospital Form 2552-1996, Hospital Form 2552-2010 , SNF Form 2540-1996, SNF Form 2540-2010, HHA Form 1728-1994 and HHA Form 1728-2020 cost reports…