Hospice cost reports
Medicare cost reports for freestanding hospices, organized by level of care.
Who files
Form CMS-1984-14 is used by all freestanding hospices for cost reporting periods beginning on or after October 1, 2014. Provider-based hospices report on their parent’s form: hospital-based on the CMS-2552, SNF-based on the CMS-2540, and HHA-based on the CMS-1728.
Current form and instructions
Instructions are in PRM-2 Chapter 43, currently Transmittal 8. Cost data must be on the accrual basis of accounting (with an exception for governmental providers on a cash basis). An electronic cost report and supporting documentation go to your MAC.
What’s in the report
A plain-English map of the main worksheets.
| Worksheets | What they cover |
|---|---|
| Worksheet S series | Certification, hospice identification, unduplicated enrollment days by level of care (routine home care, continuous home care, inpatient respite, general inpatient), contracted days, and the reimbursement questionnaire. |
| Worksheets A and A-1 to A-4 | Trial balance of expenses, plus direct costs by level of care: continuous home care, routine home care, inpatient respite care, and general inpatient care. |
| Worksheets A-6, A-8, A-8-1 | Reclassifications, adjustments, and related-organization and home office costs. |
| Worksheets B and B-1 | Allocation of general service costs, including cost centers such as volunteer service coordination. |
| Worksheet C | Average cost per diem by level of care and in total. |
| Worksheets F, F-1, F-2 | Balance sheet, changes in fund balances, and revenues and operating expenses. |
Where hospices get tripped up
Low or no Medicare utilization
Worksheet S uses the same F / L / N status. A low-utilization report requires contractor approval before you submit it. A no-utilization hospice still files a signed statement with the certification page.
PS&R reconciliation
Worksheet S-2 asks whether the report was prepared from the PS&R or from the PS&R plus your records. It requires the PS&R “Paid Claims Verified Current As Of” date and a documented crosswalk for adjustments.
Hospice cap report is separate
The hospice cap determination report is a separate filing. Failing to file it on time also triggers an immediate payment suspension until an acceptable report is filed.
Deadlines and consequences
- Due on or before the last day of the fifth month after your cost reporting period closes, or 150 days after period end if it ends mid-month.
- A cost report is also due for a short period ending on a termination or change of ownership.
- Extensions only for extraordinary circumstances beyond your control, such as flood or fire.
- Late or unacceptable: Medicare payments are suspended immediately until an acceptable report is filed.
After you file
- Your MAC decides within 30 days whether the report is acceptable. A rejected report is treated as never filed.
- Accepted reports are desk reviewed and may be audited, then settled with a Notice of Program Reimbursement.
- Filed reports enter CMS’s Healthcare Cost Report Information System (HCRIS), which CMS publishes as public data.
How we help hospices
- Confirm whether you need a full, low-utilization, or no-utilization report, and request MAC approval where it’s required
- Build Worksheet A from your working trial balance, with reclassifications and adjustments documented
- Reconcile statistics and payments to the PS&R and document the crosswalk
- Prepare the electronic file and support package for MCReF
- Answer MAC desk review and audit questions
When we start, we’ll send you a records list tailored to your agency. Request a consultation →
Get your next cost report on the calendar
Tell us your agency type, fiscal year end, and MAC. We’ll follow up to talk through scope, timing, and what we need from you.