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2 must-know updates for the Medicare cost report

Home health and hospice agencies are likely familiar with the Medicare cost report, which contains utilization data costs and charges by cost centers, allowing CMS to determine potential rate increases or decreases.

While agencies put significant effort into this report, they may not be taking the time to ensure the accuracy of the data being reported. This is an important factor because data being “close enough” can have a negative impact on agencies in the future since it’s used for determining reimbursement rates.

Since the end of 2020 and early 2021, there have been two updates to the Medicare cost report that could also make a significant impact on agencies.

1. Disciplines are now separated.

Before this update, disciplines like nursing, physical therapy, and occupational therapy were combined in the Medicare cost report. Now, specifically, as it relates to the S3 part one for home health agencies, CMS requires disciplines to be broken out—which includes RN, LPN, PT, PTA, OT, and OTA, as well as Medicare, Medicaid, and others.

Agencies will need to make sure that they’re able to obtain information like how many RN visits were done under Medicare and other payers, how many patients were served within the different disciplines, and the number of patients for an unduplicated amount (you may have done 13,000 nursing visits, but only have seen a few hundred patients).

2. Deadlines are extended due to the public health emergency.

Due to the challenges caused by COVID-19, Medicare cost report submission deadlines have been extended, giving agencies a few additional months to gather and submit their data. This extension applies to all provider types and does not require a request or notification to the MAC. Revised due dates are based on fiscal year-end, with the last remaining FYE as December 31, 2020. The due date for this FYE was extended to August 2, 2021.

You can find more details on this extension via CMS.

While these two Medicare cost report updates can benefit your agency, it’s still important to ensure data is accurate to help determine reimbursement rates—the true purpose of this reporting process.

Questions about what you just read? Let’s connect!

Amy Anderson
Amy Anderson

Amy is a Senior Product Manager at MatrixCare and has over 20 years of experience in home-based care technology. With a laser focus on data and analytics, Amy helps providers optimize their clinical operations.

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