Cost reporting / audit

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Outlier reconciliation criteria for IPPS and LTCH PPS hospitals

View this information about outlier reconciliation criteria for IPPS and LTCH PPS hospitals and the latest CMS change request.

Tools & forms: Compliance / Review

Access tools and forms related to the prior authorization program, CERT, and provider audit.

Tools & forms: Compliance / Review

Access tools and forms related to the prior authorization program, CERT, and provider audit.

Provider audit master information form

This form is used by Medicare Part A providers who change the default or other contact who receives their interim rate, tentative settlement, NPR & NOC-PR determinations.

Medicare Advantage (MA) supplemental wrap-around payments -- reason code 37098

Medicare Advantage (MA) supplemental wrap-around payments -- reason code 37098 for federally qualified Health centers (FQHCs) that have a written contract with an MA organization.

Approved cost report vendors

CMS has approved the following cost report software vendors for the electronic submission of yearly Medicare cost reports.

Provider Reimbursement Manual

View various sections of the Provider Reimbursement Manual applicable to audit and reimbursement.

Understanding provider statistical and reimbursement (PS&R) report registration

Registration External user services (EUS) help MAC help PS&R request help

FY2027 hospital wage index home page

View the FY27 wage index home page to find the timetable and PUF

Low and no Medicare utilization cost reports

This defines what is required when filing a low or no utilization cost report.