The penalty for not filing the cost report timely is that 100 percent of any payments will be withheld. In addition, providers will be assessed interest at the prevailing rate at the time the cost report is due. Furthermore, if the cost report cannot be submitted by the due date, providers may request a reduced payment suspension rate of 50 percent during a grace period of 60 days. This request should be submitted before the due date of the cost report. On the 61st day, if the cost report has not been filed, the rate of suspension will change to 100 percent.

Please contact our cost report control inbox at FCSOSettlement@fcso.com, with questions regarding cost reports.

For standard fiscal year ends, the cost report is due five months after the fiscal year end (FYE) date (the last day of the fifth month). For nonstandard fiscal year ends due to a change of ownership or a termination, etc., the cost report due date is the greater of 150 days from the FYE or 37 days after the cost report reminder letter has been sent to the provider. If the due date falls on a holiday or weekend, the cost report is due the next business day.

Reference

As explained by CMS in the calendar year (CY) 2025 final rule:

Under Medicare Part B, certain types of services, including services incident to physicians’ or practitioners’ professional services, are required to be furnished under specific minimum levels of supervision by a physician or practitioner. For most services furnished by auxiliary personnel incident to the services of the billing physician or practitioner, direct supervision is required. 

No. The services provided by physical therapist assistants (PTAs) cannot be billed incident-to a physician/non-physician practitioner’s (NPP), because PTAs do not meet the qualifications of a therapist. Only the services of a licensed/registered physical therapist can be billed incident-to a physician service. PTAs may not provide evaluation services, make clinical judgments or decisions, or take responsibility for the service. PTAs act at the direction and under the supervision of the treating physical therapist and in accordance with state laws.

Refer to section 8 of the SPOT User Guide.

Refer to section 6 of the SPOT User Guide.