Blog, Cost Report, Reimbursement

Top 5 Questions from our Cost Report 101: Part 2 Webinar

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Jeff Wolf

Completing your Medicare Cost Report can be a challenge. BESLER’s Director of Reimbursement, Jeff Wolf, answers your questions from our Cost Report 101: Part 2 Webinar. 


  1. When do you request your PSR for the Cost report?
    I recommend that you request the PSR 1 month prior to filing your cost report. That way you have the most approved bills included in the PSR.
  2. How do you create the Medicare Only Revenue and usage file? And why is this important?
    In most cases, a Provider can get a copy of the Revenue and usage file including the Primary Payor for each entry. If you have that sort the data by the Primary Payor and only use the Medicare Data.  The reason that you want to do that is to ID the service mix provided to Medicare patients which can be significantly different from young adults.
  3. Can the cost to charge ratio also be your margin percentage? 
    The cost to charge ratio represents the percentage of each billed dollar that represents your break even cost. However, this ratio does not take into account the contractual adjustments that you have with the Payors.
  4. Are imaging related drugs (ex. contrast) reclassed to 73.00 or stay with the applicable imaging line?
    Most important thing is the matching principle (i.e.: the charges should stay with the expense). Medicare specifically identifies that they want drugs charged to patients to Line 73.00.
  5. Do we need to capture 340B drug waste for the cost report?
    The Drugs for the 340B program should be separately identified and the revenue treated consistently. My recommendation is to place the 340B drugs cost on a separate cost report line (i.e. 73.01) and that would include the waste. This will allow you to properly cost the items but it will not co-mingle the 340B drugs withe the regular drugs of the facilities. This is not a requirement, but I find it the best practice.

To listen to Jeff’s Cost Report 101 – Part 2 webinar, click here

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