Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 10.11.9

Methodology for Calculation of CCR for CMHCs

Last amended: 2021Year: 2021Length: 179 wordsOfficial source
10.11.9 - Methodology for Calculation of CCR for CMHCs (Rev. 10869; Issued: 07-14-21; Effective: 08-13-21; Implementation: 08-13-21) Calculate the CMHC’s CCR using the provider’s most recent full year cost report, Form CMS 2088-92, and Medicare cost and charges from Worksheet C, Page 2. Divide costs from line 39.01, Column 3 by charges from line 39.02, Column 3 to calculate the CCR. Calculate the CMHC’s CCR using the provider’s most recent full year cost report, Form CMS 2088-17, and Medicare cost and charges from Worksheet C. Divide costs from line 50, Column 5, by charges from line 50, Column 4, to calculate the CCR. If the CCR is above 1.0 enter the appropriate Statewide average urban or rural hospital default ratio that is in the OPSF for the CMHC. There is no lower limit for CMHC CCRs. Use the CCR you calculate and do not substitute the Statewide average urban or rural hospital default ratio in cases where the CCR is below 1.0. Note that CCR reporting requirements in §10.11 apply to both hospitals paid under OPPS and to CMHCs.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 10.11.9: Methodology for Calculation of CCR for CMHCs | Justis AI