On the HHA Medicare cost report (CMS Form 1728-20), Schedule C is the final determination of cost per visit and total Medicare cost for the year.

It reports total cost per discipline in Column 2. Total cost includes both direct costs from Worksheet A (adjusted, plus or minus, by A-6, A-8, and A-8-1) and all allocated overhead costs from Worksheet B. Total visits are reported in Column 3, which is used to calculate average cost per visit (Column 4). That average cost per visit is then multiplied by Medicare visits per the PS&R (Column 5) to arrive at Medicare program costs (Column 6).

Worksheets D and D-1 serve a different purpose — they report actual reimbursement paid by Medicare and any settlement amounts. On HHA cost reports, settlement amounts generally arise only from vaccines. The vaccine settlement is calculated using drug costs from Worksheet A, line 26, based on the ratio of charges reported on Schedule C, Part II, line 12. In that sense, Schedule C does influence Worksheet D, Part I, and plays a key role in determining vaccine reimbursement.

The F-series worksheets are informational, reporting balance sheet data and revenues. They don’t affect reimbursement — though during the COVID-19 Public Health Emergency, the revenue figures reported on these worksheets were used to help determine PHE fund allocations.

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Disclaimer: This blog does not contain legal advice. What it does contain are our best explanations, advice, and suggestions to help facilities and cost report preparers to understand the cost report forms and reporting process and offer suggestions for their preparation. Progressive Provider Services assumes no legal responsibility for the content of this blog, nor for cost reports or other reports prepared based on the content herein.