This page contains the current period cost reporting forms and instructions.
For cost reporting forms and instructions applicable to prior periods, click here.
Left click on the file name to preview the file in your web browser. Right click on the file name and select "Save Target As" to save the file to your computer.
Note - You need Microsoft Word or a compatible word processor program to view the ".doc" files.
Note - You need Microsoft Excel or a compatible spreadsheet program to view the ".xlt" files.
Note - Cost Report templates have been tested with Microsoft Office 97, 2000 and XP
Medicaid Electronic Provider Cost Report Template, Version Application to 2006 and forward: Applicable to cost reporting periods that begin on or after June 1, 2006 and forward. Incorporates changes related to implementation of National Provider Identifier (NPI) number.
CR200606.xlt
Cost Report Instruction Manual, Version Applicable to 2006 and forward: Detailed page by page instructions on how to complete the cost report template 2006-06. Can be printed onto 48 letter size pages.
Instruction_Manual_CR200606.doc
Cost Reporting Problem Areas Applicable to all cost reporting periods. List of common electronic cost reporting problem areas.
Cost Reporting Problem Areas.doc
Cost Reporting Questions and Answers Applicable to all cost reporting periods. Commonly asked questions regarding the electronic cost report completion with answers to the questions.
Cost Reporting Questions & Answers.doc
Cost Report Checklist Applicable to cost reporting periods that begin on or after October 1, 2000. List of areas to be reviewed by the provider before cost report submission.
Provider Checklist.doc
Cost Report Submission Checklist Applicable to cost reporting periods that begin on or after October 1, 2000. Form must be completed and filed with all cost reports submitted.
Cost Report Submission Checklist.doc