Home health Medicare cost report

Short answer

Medicare-certified home health agencies file an annual Medicare cost report (Form CMS-1728) with their Medicare Administrative Contractor (MAC). It’s generally due about five months after your fiscal year ends and reconciles the interim payments you received against your allowable costs. Filing it late — or from disorganized books — can get your Medicare payments suspended.

What the cost report actually is

The Medicare cost report is a cost-based filing, not the same thing as your tax return or your GAAP financial statements. It maps your agency’s costs to Medicare cost centers and reconciles what Medicare paid you during the year (interim payments) against what your allowable costs support.

Home health agencies file on Form CMS-1728. It follows CMS rules for cost allocation, related-party disclosure, and statistics — which is why books kept only for tax season rarely translate cleanly.

When it’s due

The cost report is generally due five months after the end of your fiscal year (for example, a May 31 deadline for a December 31 year-end). Your MAC sets and enforces the exact date; extensions are limited and granted case-by-case.

Miss it and the consequences are financial, not just administrative: a MAC can suspend your Medicare payments until the report is filed and accepted.

What you need to file it cleanly

A trial balance mapped to Medicare cost centers — ideally maintained that way all year, not rebuilt at deadline
Payroll allocated by cost center (skilled nursing, therapy, aide, administrative)
Visit and statistical data that ties to your billing
Depreciation schedules and any related-party transactions disclosed

Where agencies get tripped up

The pattern we see: books kept on a generic chart of accounts, then a scramble to reclassify everything into Medicare cost centers in the final weeks — under time pressure, with the statistics missing. Keeping cost-report-ready books monthly turns the deadline into a non-event.

Let NavSuccess handle itWe keep home health books mapped to Medicare cost centers year-round, so the CMS-1728 is ready, not a fire drill.

NavSuccess does this for home care & healthcare agencies — see Bookkeeping & reporting.

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Common questions

Is the cost report the same as my tax return?

No. Different rules, a different form (CMS-1728), and a different due date. Cost-basis allocation and Medicare cost centers don’t come out of a standard tax filing.

What happens if I file late?

Your MAC can suspend Medicare payments until the report is filed and accepted, and repeated lateness draws additional scrutiny.

Do low-utilization agencies still have to file?

There are low- and no-utilization short-form options in some situations, but you generally still have a filing obligation — confirm your specific case with your MAC.

Primary sources

Medicare Cost Reports — CMS Home Health Agency (HHA) cost report form CMS-1728

Reviewed by the NavSuccess accounting team · Last updated August 2026. This is general education for healthcare-agency owners — not accounting, tax, or legal advice. Rules change and specifics vary by program and state, so verify against current CMS, IRS, and your state agency’s guidance, or book a consultation and we’ll confirm exactly what applies to your agency.

Medicare cost reports for home health agencies