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bservation Guidelines. Module 4 Cost Reporting. What is a cost report?. A cost report is somewhat similar to a “tax return”. Cost reports are required in order to report to Medicare and Medicaid the cost of providing services to patients.

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Bservation guidelines

bservation Guidelines

Module 4

Cost Reporting


What is a cost report
What is a cost report?

  • A cost report is somewhat similar to a “tax return”.

  • Cost reports are required in order to report to Medicare and Medicaid the cost of providing services to patients.

  • Cost reports are filed annually and provide extensive detail regarding how much it cost a hospital to provide patient care as compared to how much the hospital was paid for those services.


What is a cost report1
What is a cost report?

  • Let’s compare a cost report to a tax return.


Medicare medicaid cost report
Medicare/Medicaid Cost Report

  • Hospitals must submit a cost report that lists inpatient and outpatient costs and charges separately.

  • Cost report must be submitted within 5 months after its fiscal year end.


Observation log
Observation Log

  • For cost reporting purposes, hospitals must maintain an observation log.


Observation log1
Observation Log

  • At a minimum observation logs should include:

    • Account number

    • Patient name

    • Admission date and time

    • Discharge date and time

    • Calculated hours in observation

    • Whether patient was admitted or transferred


Cost report requirements
Cost Report Requirements

  • Observation bed days are reported on S-3 Line 26 columns 5.00, 5.01, 5.02, 6.00, 6.01, 6.02 of the cost report.


Medicare cost report
Medicare Cost Report

  • Medicare captures outpatient charges used in the settlement calculation from the Provider Statistical and Reimbursement (PS&R) report.

  • PS&R report shows detailed distribution of charges based on revenue codes billed by the hospital.


Medicaid cost report
Medicaid Cost Report

  • Medicaid captures outpatient charges used in the settlement calculation on the Hospital Statistical and Reimbursement (HS&R) report.

  • HS&R report shows detailed distribution of charges based on revenue codes billed by the hospital.


Cost reports
Cost Reports

  • Reimbursement is made retrospectively based on a cost report.

  • Only costs incurred for patient care are eligible for reimbursement.


Medicare cost report1
Medicare Cost Report

  • CAH hospitals are subject to a cash settlement of observation services after calendar year end.

  • There is NO settlement related to observation services for APC hospitals.


Medicaid cost report1
Medicaid Cost Report

  • Under Medicaid, both APC and CAH hospitals receive interim payments during the year based on a percentage of charges.

  • Therefore, both APC and CAH hospitals are subject to a cash settlement of Medicaid observation services after calendar year end.


Bservation guidelines1

bservation Guidelines

Module 4

Cost Reporting

If you have any questions or concerns regarding this course, please contact Mary Askew at maskew@draffin-tucker.com.