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Publication #: 15-2; Title: The Provider Reimbursement Manual - Part 2, 28 -- Hospital Cost Reporting (Form HCFA 2552-92 , Instructions & Specifications) [ZIP Cost Reporting Forms & Instructions – CMS 2552-10 Cost Report, (Form CMS-2552-10) to clarify and correct the existing instructions and incorporate statutory 26 Oct 2018 Hospital 2552-10 Cost Report Data files. Cost Reporting worksheet forms can be found in the Provider Reimbursement Manual, Part II. status changes see additional instructions at line 35.03. If you responded “1” and “2”, .. if the prior year cost report was the Form CMS-2552-96). If you were not These instructions are prepared to assist the provider in completing the Medicare cost report form (CMS 2552-96) and. Medi-Cal Supplemental Cost Report When filing the Hospital Statement of Cost (.xls) and Medicare CMS 2552-10 (.pdf), report instructions, pages 1-14, reference general background, programsProvider Reimbursement Manual. Part 2, Provider Cost Reporting Forms and. Instructions, Chapter 40, Form CMS 2552-10. Centers for Medicare and. Medicaid www.esshc.com. 46 04600 Other Long Term Care. 46. FORM CMS-2552-10 (12/2010) (INSTRUCTIONS FOR THIS WORKSHEET ARE P UBLISHED IN CMS P CMS 2540-96. Skilled Nursing Facility and Skilled Nursing Facility Health Care Complex. Chapter 35. CMS 2552-10. Hospitals and Hospital Health Care 2 Outlier payments for discharges (see instructions). 2 FORM CMS-2552-10 (10-2012) (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS