Electronic Cost Report Exhibit Templates

In support of efforts to streamline the Medicare Cost Report (MCR) process for participating providers, CMS is supplying optional electronic versions for key MCR exhibits. Utilizing these optional electronic versions will aid MACs in reviewing supporting data from providers, and reduce the need for rejections, amendments, and follow-up communication about MCR submissions. When used in combination with the Medicare Cost Report e-Filing system (MCReF), providers will also receive additional pre-emptive feedback about potential issues with the information in their exhibits.

The MCR instructions include the definitions of and requirements for exhibits supporting various reimbursements being claimed in the cost report. These exhibit instructions include a visual layout of the requested information, as well as definitions of the expected fields and rules that the recorded information is required to follow.

In support of these exhibits, CMS provides optional electronic specifications for creating digital versions of the exhibits that enable enhanced troubleshooting and accelerated cost report processing if filing through MCReF. These specifications contain file naming conventions that will enable MCReF to automatically identify what kind of file is being submitted, as well structure and label information to construct a spreadsheet file (.xlsx or xlsm format) that fulfills all of the requirements of the exhibits in the MCR instructions.

By submitting files in accordance with the specifications, MCReF is able to check the files for adherence to the cost reporting instructions and give providers feedback about potential problems with their documentation. The utilization of this standardized electronic format also enables accelerated cost report acceptance and tentative settlement.

Each specification includes an identifier to be placed at the top of each tab, the necessary field labels for conforming to the exhibit, and the specific spreadsheet locations to place those labels and corresponding data. For each field, the specifications also include whether that field is required to be populated on each row, what type of information to enter (date, number, etc.), and any other rules the recorded information must follow.

In addition to these optional electronic specifications, CMS has created pre-made templates that are arranged according to the specifications. These are blank spreadsheets with all of the appropriate worksheet identifiers and all of the field labels in the specified locations, ready for data entry.

Where possible, the templates will help guide data entry in accordance with the specifications. For example, fields expected to contain dates will be pre-formatted as dates, and fields with a specific list of valid values (for example, Yes/No fields) will have dropdowns with the valid values to choose from. The templates will not be able to enforce all rules, such as required fields. These rules will generate warning messages in MCReF, as an additional confirmation of whether a provider’s exhibit is filled out appropriately.

The following exhibits included in the MCR specifications each have a corresponding optional electronic specification, and pre-made templates to match.  These specifications and templates can be found at the bottom of the page under the “Downloads” heading.

Medicare Bad Debt Listing

The Medicare Bad Debt Listing specification has three variations, depending on the MCR version the listing is being submitted with.

• A general specification shared across the following MCR versions and exhibits
  • 222-17 – Exhibit 1
  • 2088-17 – Exhibit 1
  • 224-14 – Exhibit 1
  • 265-11 – Exhibit 1
  • 2540-10 – Exhibit 1
• MCR Version 1728-20 – Specifying the layout for Exhibit 1
• MCR Version 2552-10 – Specifying the layout for Exhibit 2A

Medicaid Eligible Days

The Medicaid Eligible Days specification is designed to accommodate the completion of Exhibit 3A of the 2552-10 Medicare Cost Report.

Charity Care Charges

The Charity Care Charges specification is designed to accommodate the completion of Exhibit 3B of the 2552-10 Medicare Cost Report.

Total Bad Debt

The Total Bad Debt specification is designed to accommodate the completion of Exhibit 3C of the 2552-10 Medicare Cost Report.