ECR File Format & MCReF Filing
By costreporting.aiPublished
The ECR file is the Electronic Cost Report — the standardized, machine-readable representation of a completed cost report that CMS-approved software produces from the worksheets. The MAC's systems consume the ECR, not a hand-typed form, so the report must validate against the CMS specification before it can be accepted.
What the ECR actually is
The ECR is a fixed-layout record file: every worksheet cell that carries a value is emitted as a record keyed by worksheet, line, and column, following the CMS specification in the Provider Reimbursement Manual for the provider's form (CMS-1728-20 for Home Health, CMS-1984-14 for Hospice). It is generated, not edited by hand — which is why the upstream classification and reconciliation have to be correct before export.
Input data: the PS&R report
The PS&R report — Provider Statistical and Reimbursement Report — is the standardized claims-summary report CMS generates for each provider through the MAC and the Common Working File (CWF). It contains visit counts, charges, payments, denials, and related statistics by HCPCS / revenue code for the provider's fiscal year. **The cost report's statistical worksheets (Worksheet S series; provider-type specific) must reconcile to the PS&R data** — that is, the visit counts and Medicare-payment totals the provider reports on the cost report must match what CMS's claims system says was paid. If the cost report and PS&R do not tie out, the report will trigger MAC questions during desk review. Most providers pull the PS&R as one of the first preparation steps each year — it's the ground-truth statistical input the cost report is built on top of.
How the report reaches the MAC: MCReF
Providers submit through MCReF, the Medicare Cost Report e-Filing portal — the provider's authorized representative uploads the ECR (and supporting documentation) and the MAC acknowledges receipt. The cost report is the annual reconciliation; MCReF is only the transmission step. A report that is internally inconsistent will be rejected after submission, so getting the ECR right before it leaves your hands is what matters. costreporting.ai produces a CMS-spec-conformant export and traces every emitted value back to its formula and inputs.
Sources
- CMS Manual:Provider Reimbursement Manual, Part 2 (Pub. 15-2) — electronic cost report (ECR) specifications
- Source:CMS Medicare Cost Report e-Filing (MCReF) — submission system
- Regulation:42 CFR § 413.24(f) — required filing of the cost report
- Source:CMS PS&R (Provider Statistical and Reimbursement Report) — claims-summary data source providers reconcile the cost report against