Dear Colleagues,

The last few weeks I’ve fielded many questions related to CMS requiring hospitals to report their payer contracted rates in the cost reports.

Let me provide a quick refresher on this issue. On Monday, May 11, 2020, CMS’s Proposed Rule requires hospitals to report, on its cost report:

(1) The median payer-specific negotiated rate that the hospital has negotiated with all of its Medicare Advantage payers, by MS-DRG;

(2) The median, payer-specific negotiated rate the hospital has negotiated with all of its third-party payers, by MS-DRG.

The payer-specific contracted rates would have to be reported on cost reports with periods ending on or after 1/1/21.

CMS claims it is trying to set fair MS-DRG payment rates that are not based on the chargemaster, which CMS calls, “inherently unreasonable when judged against prevailing market rates.”

If your organization needs help calculating its payer-specific contracted rates for compliance, we can help. 

Here's my private calendar to set up a mutually-convenient time to talk:


Rick Louie
Managing Director

LinkedIn Profile:

Click Here to [Schedule a free 15-minute meeting with me.]

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