Home Health (HHA) Cost Report — CMS-1728-20
By costreporting.aiPublished
The Home Health cost report is the annual Medicare filing every Medicare-certified Home Health Agency submits to its MAC on Form CMS-1728-20, reconciling the agency's allowable cost of treating Medicare patients against the interim payments received during its fiscal year (42 CFR § 413.20).
What the CMS-1728-20 covers
The form walks the agency's finances from raw trial balance to Medicare settlement. Worksheet A captures direct cost by cost center. Worksheet B performs the step-down — general and administrative, plant, and capital overhead are allocated onto the six home-health disciplines (skilled nursing, physical therapy, occupational therapy, speech pathology, medical social services, and home health aide). Worksheet C applies cost-to-charge ratios; Worksheet D / H computes the Medicare-allowable share and the final settlement.
Why the worksheets must reconcile
The worksheets are not independent — totals carry forward, and the MAC will reject a report whose worksheets do not tie out. Reconciling a step-down by hand across dozens of cost centers is where most preparation time goes. costreporting.ai classifies each trial-balance account to its CMS cost center, runs the step-down deterministically, and surfaces a confidence score on every mapping — the provider reviews and stays in control, and every figure traces to an audit entry with its formula and inputs.
Common questions
What form is the home health cost report filed on?
Medicare-certified Home Health Agencies file Form CMS-1728-20. It replaced the older CMS-1728-94 for cost reporting periods beginning on or after the form's effective date and is the form a MAC expects for HHA settlements.
When is the home health cost report due?
Five months after the end of the agency's fiscal year (42 CFR § 413.24(f)(2)). A December 31 year-end means a May 31 due date. The MAC may grant a limited extension only for good cause beyond the provider's control.
What does the CMS-1728-20 actually calculate?
It takes the agency's trial balance, classifies each general-ledger account to a CMS cost center, allocates overhead to the patient-care disciplines through the Worksheet B step-down, applies cost-to-charge ratios, and computes the Medicare settlement on Worksheet D/H — the amount owed to or by Medicare for the year.
Does an HHA still file a cost report under PDGM?
Yes. The Patient-Driven Groupings Model changed how interim claims are paid, not the annual cost-report obligation. The CMS-1728-20 is still required and still reconciles allowable cost against interim payments.