Hospital Cost Report

Hospitals - NCDHB E-5

• Acute Supplemental E-5 Instructions and Schedule FYE 2021
• CAH Supplemental E-5 Instructions and Schedule FYE 2021

Hospital Information

• Hospital Cost Report Information Sheet - April 24, 2020
• Rate Adjustment Eligibility Worksheet - Due Oct. 1, 2025
• Hospital Schedules A&C for DSH - Due Oct. 1, 2025
• Hospital Schedule B for DSH
• Hospital Change Form

Archive

Contacts

NCDHB E-5
NC Medicaid Finance Section

Phone: 919-527-7169
Fax: 919-716-0600

DSH Schedule A, B and C
NC Medicaid Finance Section

Phone: 919-527-7179
Fax: 919-716-0600