Cost Report Filing

Published 08/14/2025

Medicare cost reports are required to be filed each year. A cost report normally covers a 12-month period and must be submitted within five months of the end of provider’s cost reporting period.

Filing the cost report before the due date is strongly recommended, as filing late results in payments being suspended while filing early establishes a grace period in the event the report is rejected, allowing time to correct and resubmit the report before payments are suspended.

Filing a cost report even a few days late can result in suspended payments for an extended period of time. Suspended payments are not released until the cost report is received and determined to be acceptable. During busy periods, such as the month of June, it may take 30 days to accept the cost report.

Obtain Access to MCReF
The Medicare Cost Report e-Filing (MCReF) system is provided by the Centers for Medicare & Medicaid Services (CMS) to simplify the process of submitting a Medicare Cost Report. MCReF is a secure portal for the transmission of documents (including PII/PHI). Files uploaded are not to be encrypted or password protected. Benefits of using MCReF include:

  • Electronic signature is accepted
  • Postage expense is eliminated
  • PHI is secure
  • Confirmation of receipt is received immediately

See Medicare Cost Report e-Filing (MCReF) for information on how to access and use the system. This includes a video overview and a detailed user manual. 
 

Obtain PS&R Report 
Providers are required to obtain their own PS&R report(s) for use in preparing the cost report. Please refer to the following articles for instructions on accessing the system and ordering reports. 

Standard Templates 
To streamline the Medicare Cost Report process, CMS provides electronic versions of key cost report exhibits. By using the CMS-provided (optional) version of the exhibits, there should be a reduced need for follow-up communication regarding the cost report submission. When filing using MCReF, a provider will receive preemptive feedback about potential issues with their exhibits.

Click Electronic Cost Report Exhibit Templates to view the entire article in CMS.gov. This section provides information about the exhibits and the Downloads section contains exhibits/templates in an Excel file and specifications/directions in a PDF file. A direct link to the exhibit/template is included below.

Home Health (1728-20)
A template for reporting Medicare bad debts can be found here: Medicare Bad Debts (Exhibit 1) — HHA 1728-20 (XLSX). The specification document for the template is in the Downloads section of Electronic Cost Report Exhibit Templates.

Submit Cost Report
Providers are encouraged to file the cost report and all documentation through MCReF. If MCReF is not used, cost report can be mailed. However, do not both submit through MCReF and mail a copy. All submitted cost reports are subject to a desk review and/or an audit.

When making a submission, please be sure to include schedules or working papers for reclassifications, adjustments, related organizations, contracted therapists, and protested items. 

MCReF 

  • Ensure all files are uploaded, including the electronic signature page 
  • Attach cost report files in their native format 
  • Bad debt lists should be sent in an Excel file format

Mailing

  • Include a printed signature page so the cost report can be identified
  • Ensure the cost report is signed (electronic signature is acceptable)
  • If signing with a pen, use blue ink
  • Place cost report files and supporting documents on a disk or flash drive
  • Do not send printed copies of the cost report or documents 
  • If sending reports for multiple providers, clearly identify and place files on separate disks
  • Attach cost report files in their native format 
  • Bad debt lists should be sent in an Excel file format
  • Limit paper documents to only the signed, signature page (with encryption codes)
Table 1. Mailing Addresses.
Courier Service U.S. Postal Service
Palmetto GBA
JM Cost Report Acceptance (AG-330)
2300 Springdale Drive, Building One
Camden, SC  29020-1728
Palmetto GBA
JM Cost Report Acceptance (AG-330)
 PO Box 100144
Columbia, SC  29202-3144

For cost reports sent through the mail, the date mailed is based on the U.S.P.S. postmark and not the date from a postage machine. If a U.S.P.S. postmark is not on the package, the receipt date will be used as the postmark date.


Medicare issues standard forms for the preparation of provider cost reports. These forms are available for viewing and reference in CMS Publication 15-2, The Provider Reimbursement Manual, Part 2. Below are links to forms by provider type. In opening the link, the form is indicated by a “f” at the end of the file name and the instruction with an “i."
Table 2. Cost Report Forms.
Form Provider Type Latest Version
CMS 287-05 Home Office Cost Statement Chapter 39
CMS 1984-14 Hospice Chapter 43
CMS 1728-20 Home Health Agency Chapter 47
Medicare cost reports are prepared in an electronic format using software from a CMS-approved vendor. The electronic format consists of an Electronic Cost Report (ECR) file of the cost report and a Print Image (PI) file. A signature page with encryption codes that match the ECR and PI files should also be included. The cost report can be signed with an electronic signature. (The exception is the Home Office form, CMS 287-05).

Approved Vendor Software Listing

Transmittal Approvals as of June 30, 2025

Table 3. Approved Software Vendors.
Vendor Vendor Code CMS-1728-20
HHA
CMS-1984-14
Hospice
CMS-287-22
Home Office
Health Financial Systems
becky@hfssoft.com
Becky Dolin
(888) 216–6041
P.O. Box 850
Elk Grove, CA  95759
05 Yes Yes Yes
Optimizer Systems, LLC
jonathan@winlash.com
Jonathan Jackson
(215) 665–3990
26 Ives Farm Ln
Hendersonville, NC  28739
02 Yes Yes Yes
Progressive Provider Services, LLC
blimi@ppsassistant.com
Blimi Schwartz 
(248) 968–4100, 800–447–2540 
2255 Sheridan Blvd., Unit C335 
Edgewater, CO  80214
31 Yes Yes Yes
Manis & Ryan (Patrick Manis)
pmanis@manisandryan.com
(805) 523-7364
20945 Devonshire St., Suite 201B 
Chatsworth, CA  91311
35 Yes

 

 

No Medicare Utilization — Submit a statement on the agency’s letterhead, signed by an authorized official, identifying the MCR period. The letter must state that no covered services were furnished during the reporting period, and that no claims for Medicare reimbursement will be filed for this reporting period. Submit the signed worksheet S (certification page) of the MCR.

Low Medicare Utilization — An option if Medicare reimbursement is less than the following thresholds:

  • Federally Qualified Health Clinic (FQHCs) = $50,000
  • Rural Health Clinics (RHCs) = $50,000
  • Community Health Mental Health Clinics (CMHCs) = $15,000 (and no outlier payments reported on the PS&R)
  • All other provider types (hospital, SNF, HHA, hospice, etc.) = $200,000

Submit the following:

  1. Page one of the applicable cost report form 
  2. Signed officer certification sheet
  3. Balance sheet 
  4. Statement of revenues and expenses

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