Cost reporting / audit
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.