Cost Report Filing

Published 06/30/2023

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 
  • 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 

Please note that filing a cost report even a few days late, can result in an extended period of suspended payments. Suspended payments are not released until the cost report is received and determined to be acceptable. In 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:

  • 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 about MCReF, plus 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. 

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 submit through MCReF and mail a copy. 

Please review the following in making a submission. And, ensure to include schedules or working papers for reclassifications, adjustments, related organizations, contracted therapists, and protested items. 

Please note that all submitted cost reports are subject to a desk review and/or an audit.


  • 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


  • Included 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)
Courier Service U.S. Postal Service

Palmetto GBA
JM Cost Report Acceptance (AG-330)
2300 Springdale Drive, Building One
Camden, SC  29020-1728

U.S. Postal Service
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."


Provider Type

Latest Version

CMS 287-05

Home Office Cost Statement

Chapter 39

CMS 1984-14


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 (see below). The electronic format consists of an Electronic Cost Report (ECR) file of the cost report and a Print Image (PI) file. Plus, a signature page with encryption codes that matches the ECR and PI files. The cost report can be signed with an electronic signature (with the exception of the Home Office form, CMS 287-05).

Approved Vendor Software Listing

Electronic cost report filing is not required for these less than full cost reports. The documents can be mailed to the address noted above.

No Medicare Utilization — Submit a statement on the agency’s letterhead, signed by an authorized official, identifying the MCR period. This must state 1) no covered services were furnished during the reporting period, and 2) no claims for Medicare reimbursement will be filed for this reporting period. In addition, 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) = $50,000Community 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 and 4) statement of revenues and expenses.

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