Simione™ Healthcare Consultants

CMS Issues Changes to HHA Cost Report

On October 1, 2020, CMS issued a new home health cost report (Form CMS-1728-20), which is retroactive for Home Health Agencies (HHAs) with fiscal years beginning on or after January 1, 2020. The changes to the cost report affect all freestanding HHAs and freestanding HHA-based Hospices. As the largest preparer of Medicare cost reports in the industry, Simione Healthcare Consultants wants to ensure that agencies are able to extract all of the necessary data from EMR software and GL software packages for inclusion in the Medicare cost report.

Director Maureen Laskowski says, “We saw how important the cost reports were in the calculations used to build the new PDGM reimbursement model and we continue to stress the importance of the completeness and accuracy of all Medicare cost reports. We’re here to assist in adopting the changes and keeping cost reports timely, accurate and meeting all requirements.”

The new HHA cost report requires significantly more detail in the breakout of visits, patients, salaries, benefits, contract pay, and hours by discipline and by payer.  If not already underway, agencies need to start breaking out data on professional and paraprofessional staff.  Simione can assist HHAs with the preparation of financials and EMR reports with these added levels of detail. 

View the CMS Detailed Instructions and Forms

Download This Full Summary


A Summary of the Significant Changes

Statistics for visits and patients must now be reported by payer for:

  • Traditional Medicare
  • Traditional Medicaid
  • Other (includes Medicare Advantage, Commercial Insurance, Self-Pay, etc.)

Statistics for visits and patients must now be reported with discipline detail, breaking out:

  • Skilled Nursing
    • Registered Nurses (RNs)
    • Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs)
  • Physical Therapy
    • Physical Therapists (PTs)
    • Physical Therapy Assistants (PTAs)
  • Occupational Therapy
    • Occupational Therapists (OTs)
    • Certified Occupational Therapy Assistants (COTAs)

In addition to visits and patients, HHAs must breakout the following with the new level of detail for Skilled Nursing, Physical Therapy, and Occupational Therapy:

  • Salaries
  • Benefits
  • Contract Pay
  • Paid hours related to salaries/contract pay

HHAs are now required to breakout the following cost centers:

  • General Service Cost Centers:
  • Telecommunications Technology (remote patient monitoring)
  • Nursing Administration
  • Medical Records
  • HHA Reimbursable Services
  • Skilled Nursing
    • RNs
    • LPNs
  • Physical Therapy
    • PTs
    • PTAs
  • Occupational Therapy
    • OTs
    • COTAs
  • Disposal Devices (non-pressure wound therapy devices)
  • HHA Non-Reimbursable Services
    • Advertising
    • Fundraising
    • Telehealth

Lastly, HHA revenues must include the following details:

  • Gross patient revenues and contractual allowances by the following payors:
    • Medicare
    • Medicaid
    • Other
  • Line 31.50 report monies received for Covid-19 Public Health Funding
    • Includes both PRF and SBA loan forgiveness

Simione is committed to helping HHAs adopt required changes and related data analysis to support timely and accurate filing. Call 800-949-0388 or visit

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