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Medicare Cost Reporting Updates - 7 Things to Know

Posted by Stacie Snider on Oct 24, 2018 1:56:42 PM

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medicare cost reportingThe Centers for Medicare and Medicaid Services (CMS) has made updates to the cost reporting software, the rules for filing a hospital Medicare cost report and noted future potential changes.  Here are 7 things to know:

  1. The Low Volume Adjustment has been extended to 2022. There will not be a reconciliation on the back end of reporting.

  2. There are a number of new cost report software edits:

    1. Nursing school and allied health data must now be sub-scripted. Hospitals can no longer group these two categories into the same cost center.

    2. Hospitals must separately report Psych 'Lab and Drugs' charged to patients on lines 60 and 73, respectfully. In addition, these lines cannot be zero.

    3. All types of cost reports will now have the electronic signature box available.

    4. CMS has extensively increased the number of level 1 error checks in the cost reporting software.  Please note, a level 1 error on the cost report will not allow the Electronic Cost Report (ECR) to be filed.

  3. CMS is encouraging hospitals to use electronic signatures and submit all required documents electronically. Hospitals not currently using the electronic signature feature must complete an application process and allow ample time for approval.

  4. Contractors are now required to pull a PS&R to verify whether a hospital must file a cost report. If there are charges and reimbursement on the PS&R, hospitals will be required to file a Medicare cost report. This change will affect those those hospitals that have not historically filed reports but have had charges and reimbursement on their PS&Rs (i.e. hospitals who previously filed no utilization cost reports).

  5. Facilities with SNF-based Hospice programs must have costs and charges for each level of care they provide. These must tie back to the S-8 worksheet.

  6. End-Stage Renal Disease (ESRD) cost reports cannot count services furnished to patients in their home as a facility based visit.

  7. Hospitals that have the same year end as their home office will be required to file both their home office cost report and their hospital cost report to not only the hospital’s MAC but to all home office servicing MACs.

ON THE HORIZON: CMS is requiring teaching hospitals to include Intern and Residents support that will tie back to the cost report with their cost report submission. This means including actual Interns and Residents data documentation, not just the IRIS disk. Hospitals need to ensure they can support the numbers they are including on their cost report with auditable data.


Freestanding SNFs will begin doing wage index. The facilities may want to re-familiarize themselves with the current wage index regulations.


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Topics: cost reporting, Medicare Cost Report

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The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
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  • Litigation Surrounding Provider Reimbursement

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