Medicare Financial Management Manual (Pub. 100-06), Ch. 1 § 130.1
Completing the Schedule of Other Costs (Schedule B) - (Rev. 1,
130.1 - Completing the Schedule of Other Costs (Schedule B) - (Rev. 1,
08-30-02)
A1-1216.1, B1-4216.1
A. General
The contractor shall use this schedule to identify specific other costs included in the
Other Costs line of the Activity Screen as defined in §90.9 F. A separate Schedule B is
completed for each activity requiring the specific identification of other costs.
B. Uses
The contractor shall complete this schedule only with the concurrence of CMS. It may
not be required of all contractors. If required, the schedule may be used for the BR, SBR,
IER and/or FACP.
C. Explanation of Entries on the Schedule B
1. Code - A three-digit code identifying each cost item. The contractor shall use 999 to
identify all remaining costs not requiring specific identification.
2. Description - A brief description of the discrete cost item. Types of costs to be
reported are described in §90.9 F. Those items requiring identification will depend on the
nature of the contractor's contract/agreement, materiality and other considerations. The
classification of costs in its cost accounting system, government regulations and the
contract/agreement will determine whether the cost is classified as an Other Cost.
3. Total Cost - The contractor shall report the total cost for each item. The total for all
Other Costs, including those reported under 999 if applicable, must agree with the total
reported on the Other Direct Costs line of the Activity Screen.