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January 12, 2015

Home Health and Hospice Cost Report Submission Reminders

When preparing and sending the Home Health or Hospice cost reports to CGS, as your J15 MAC, please remember the following:

  • Include Worksheet S with encryption codes and original signature of Officer or Administrator.  Sign in blue ink so that it can easily be identified as an original signature.
  • CMS Form 339 with original signature of Officer or Administrator and applicable supporting documents.  Sign in blue ink so that it can easily be identified as an original signature.
  • Include documentation to support total flu vaccine cost and charges submitted on the Home Health cost report.
  • Include the following documentation (if applicable) to support the total flu vaccine and supply cost for the fiscal year.
    • Invoices for the flu vaccine and supplies shown on Worksheet A, line 13, column 10 of the cost report.
    • A summary by payer for all flu vaccines given.  Including the shots discarded or given to employees at no charge.  The summary of shots by payer should match the number of shots purchased.
    • Trial Balance
  • Also remember to include the Sequestration amount from Report 342 of your PS&R along with the other Part B reports to include on Worksheet D.
  • Please do not submit other Medicare forms with your Cost Report, such as Credit Balance.  Submitting multiple Medicare forms together may result in misrouting and a delay in processing.
  • If you are completing cost reports for multiple providers, please submit each cost report separately.  This will help our mail room to avoid scanning multiple cost reports together and could delay our processing of your cost report and cause your provider to be put on withhold.
  • Mail cost reports to:

    CGS Administrators
    J15-HHH Audit and Reimbursement
    PO Box 20015
    Nashville, TN  37202

    (If payment is due to Medicare, send a copy of the check with your cost report.)

  • If payment is due to Medicare, mail the check to:

    CGS Administrators
    J15 HHH Region B
    PO Box 957124
    St. Louis, MO 63195-7124

  • Cost reports can be returned to you for the following reasons:
    • Submitting a cost report before the fiscal year has ended
    • Submitting a cost report to the wrong MAC
    • Submitting a cost report for a terminated provider before the Enrollment department has confirmed the termination notice.
  • If you have more questions, please visit our website page.
  • For Cost Report Receipt questions you can also call 515-471-7470

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