Hospital Cost Report

Hospitals - NCDHB E-5

• Acute Supplemental E-5 Instructions and Schedule FYE 2019 
• CAH Supplemental E-5 Instructions and Schedule FYE 2019
• Acute Supplemental E-5 Instructions and Schedule FYE 2018
• CAH E-5 Instructions and Schedule FYE 2018
• Supplemental E-5 Instructions and Schedule FYE 2017
• CAH E-5 Instructions and Schedule FYE 2017
• Treatment of Hospital Provider Assessment (Provider Tax) in Medicaid Cost Reports

DSH / MRI / GAP Information

• Notice to Non-public Hospitals that are eligible to receive Medicaid Enhanced Payments - May 15, 2019
• Hospital Schedule B for DSH - Due with Cost Report
• Rate Adjustment Eligibility Worksheet - Due Oct. 18, 2019
• Hospital Schedules A&C for DSH - Due Oct. 18, 2019
• Hospital Cost Report Information Sheet
• 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