Skilled Nursing Facility (SNF) Cost Report — CMS-2540-10
By costreporting.aiPublished
The Skilled Nursing Facility cost report is the annual Medicare filing every Medicare-certified SNF submits to its MAC on Form CMS-2540-10, reconciling the facility's allowable cost of treating Medicare beneficiaries against the SNF PPS interim payments received during its fiscal year (42 CFR § 413.20). Hospital-based SNFs report SNF activity on Worksheet S-3 of the parent hospital's CMS-2552-10 instead.
What the CMS-2540-10 covers
The CMS-2540-10 walks the facility's finances from raw trial balance to Medicare settlement. Worksheet A captures direct cost by cost center. Worksheet B performs the step-down — administrative and general, plant operations, and capital overhead are allocated to the patient-care cost centers (routine nursing, intensive care, ancillary services). Worksheet C applies cost-to-charge ratios and computes per-diem cost. Worksheet D / E computes the Medicare share and reconciles against SNF PPS payments to produce the final settlement variance.
SNF support: pilot status + roadmap
costreporting.ai currently supports HHA (CMS-1728-20) and Hospice (CMS-1984-14) for the November 2026 pilot cohort. We're building the platform deliberately one form at a time — the deterministic engine, audit-trail, and cost-finding methodology must be exactly right for each form's worksheet structure before we add the next. SNF (CMS-2540-10) is on the post-pilot roadmap. Join the waitlist below if you'd like notification when SNF support ships.
The 42 CFR § 413.24 cost-finding standard applies regardless of provider type, so the architectural principle (AI classifies, determinism calculates, every customer-visible number traces to an audit-trail entry) carries forward when SNF support lands. Whether you use a CPA firm, a billing agency, or an independent consultant for filing today, the documentation standard is the same, and your authorized representative signs the cost report regardless of preparer.
Common questions
What form is the SNF cost report filed on?
Medicare-certified Skilled Nursing Facilities file Form CMS-2540-10. It is the form a MAC expects for SNF cost-report settlements. Hospital-based SNFs file the SNF data on Worksheet S-3 of the parent hospital's CMS-2552-10.
When is the SNF cost report due?
Five months after the end of the facility's fiscal year, per 42 CFR § 413.24(f)(2). The MAC may grant a limited extension only for good cause beyond the provider's control. The deadline is the same five-month rule that applies to other Medicare cost-report filers.
What does the CMS-2540-10 calculate?
It captures the facility's trial balance, allocates direct and indirect cost across cost centers using step-down apportionment per PRM Pub. 15-1 Chapter 23, computes per-diem cost by routine vs ancillary services, and reconciles allowable cost against the SNF PPS payments received during the year. Bad-debt reimbursement and the Worksheet B step-down statistical bases are common preparation focus areas.
Does costreporting.ai support SNF cost reports today?
Not yet. The pilot product currently supports HHA (CMS-1728-20) and Hospice (CMS-1984-14) for the November 2026 cohort. SNF support is on the roadmap for the post-pilot release. If you're a SNF operator interested in being notified when CMS-2540-10 support ships, join the waitlist below.