Form preview

Get the free CMS-2552-96

Get Form
This form is used to calculate Medicare reimbursement settlements under various payment systems including TEFRA, IRF PPS, LTCH PPS, and IPF PPS.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign cms-2552-96

Edit
Edit your cms-2552-96 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your cms-2552-96 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing cms-2552-96 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Use the instructions below to start using our professional PDF editor:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit cms-2552-96. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
Dealing with documents is simple using pdfFiller. Try it right now!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out cms-2552-96

Illustration

How to fill out CMS-2552-96

01
Gather all necessary financial records and data for the reporting period.
02
Obtain a copy of the CMS-2552-96 form from the official CMS website or your local Medicaid office.
03
Fill out the provider identification information at the top of the form including name, address, and NPI number.
04
Complete the financial data sections, ensuring to accurately report revenue and expenses associated with services provided.
05
Provide the cost reporting period dates in the designated area of the form.
06
Detail any adjustments or corrections from prior cost reports in the appropriate sections.
07
Review all entries for accuracy and completeness.
08
Sign and date the form certifying the information is true and complete.
09
Submit the form by the specified deadline to the appropriate Medicare administrative contractor (MAC).

Who needs CMS-2552-96?

01
The CMS-2552-96 form is required for institutional providers such as hospitals and skilled nursing facilities that participate in the Medicare program and need to report their costs and financial data.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
27 Votes

People Also Ask about

Medicare Part 2, Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10. This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), by clarifying and revising the existing instructions and by revising existing edits. Effective dates vary.
The PERM program is designed to measure improper payments in the Medicaid and CHIP programs. During each PERM Cycle, CMS hosts multiple provider education sessions which are presented on webinar/conference call platforms.
A cost report is a document that provides an overview of the costs associated with a project. It typically includes information about the budget, actual costs, and any variances between the two. The report can also include details about labor costs, materials, and other expenses related to the project.
CMS Telemedicine Reporting Updates CMS will not adopt the new CPT telemedicine codes (98000–98015). Instead, telemedicine visits should be reported using in-person E/M codes (e.g., 99202–99215) with: Modifier 95 for audio-video visits. Place of service codes 02 (non-home location) or 10 (telehealth in home)
The outlier fixed-loss threshold for FY 2024, which runs from October 1, 2023, through September 30, 2024, is $42,750. Centers for Medicare and Medicaid Services (CMS) pays 80% of costs exceeding DRG payment.
The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

CMS-2552-96 is a Medicare Cost Report form used by institutional providers to report their costs and services provided to Medicare beneficiaries.
Institutional providers such as hospitals and skilled nursing facilities that receive Medicare reimbursement are required to file CMS-2552-96.
To fill out CMS-2552-96, providers must gather their financial data, complete the sections of the form according to the instructions provided by CMS, and ensure all required schedules are attached.
The purpose of CMS-2552-96 is to provide Medicare with necessary cost details that are used to determine the reimbursement rates for services provided to Medicare beneficiaries.
Key information that must be reported on CMS-2552-96 includes total expenses, patient care activities, facilities costs, and any other relevant financial data required for cost determination.
Fill out your cms-2552-96 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.