NAVEOS® Reports on the Importance of the Centers of Medicare and Medicaid (CMS) Clarification on Calculating Total Bad Debt Expense in Hospital Cost Reports

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NAVEOS® reports on the importance of the Centers of Medicare and Medicaid (CMS) clarification on calculating Total Bad Debt Expense in the hospital cost report. The clarification is found in the CMS Transmittal 4 – PRM 15-2 Chapter 40 released by CMS on September 27th to update the 2552-10 cost report forms.

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This will keep hospitals from having to continuously update the S-10 every time something is written off for a date of service within that fiscal year.

On September 27, 2013, CMS issued an update to the 2013 Medicare Cost Report instructions and added additional lines to various cost report worksheets. CMS specified in Transmittal 4 that the Worksheet S-10 will treat bad debts in the same manner as every other place in the cost report and other financial reports.

The significance of this clarification is hospitals will not have to set up a separate bad debt reporting system for the Worksheet S-10. The clarification applies to Line 26 and 27 of Worksheet S-10, which report on total facility bad debt expenses and total facility Medicare reimbursable bad debts, respectively.

CMS is now requiring that the reporting of Total Bad Debt Expense on Worksheet S-10 align with how Medicare Bad Debts have been reported previously. In other words, Worksheet S-10 should report the Total Bad Debts Written-Off by the Hospital during the cost report period for balances applicable to patients. Previously, the instructions indicated that hospitals were required to report bad debts that had service dates during the cost report year, which were either written off in that fiscal year or expected to be written off at some time in the future.

For cost reports beginning on or after October 1, 2012, the hospital can now enter the amount it has written off in that fiscal year on Worksheet S-10. No longer will they have to speculate on how much will be written off in the future for services provided in that fiscal year, nor track these claims for purposes of amending the cost report.

Mike Sabo, Vice President of Regulatory Affairs for NAVEOS®, states, “This will keep hospitals from having to continuously update the S-10 every time something is written off for a date of service within that fiscal year.”


Founded by industry veteran Robert Gricius, NAVEOS® is a healthcare data analytics company that focuses on maximizing past, present and future government reimbursement streams for hospitals and other healthcare organizations throughout the United States. By utilizing their proprietary data analytics Comprehensive Online Member Population Analysis Software System (COMPASS™) system, NAVEOS® has established itself as a market leader in identifying additional reimbursements for their clients over the past ten years.

For more information, please contact Lisa Martin, Vice President of Administration at 703-870-7860 or visit the NAVEOS® website at

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Lisa Martin
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