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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
  • Notice to Non-public Hospitals that are eligible to receive Medicaid Enhanced Payments - May 17, 2021
  • Rate Adjustment Eligibility Worksheet - Due Oct. 11, 2024
  • Hospital Schedules A&C for DSH - Due Oct. 11, 2024
  • 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

This page was last modified on 11/21/2024

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Contact Information

NC Medicaid, Division of Health Benefits
2501 Mail Service Center
Raleigh, NC 27699-2501

NC Medicaid Contact Center
Phone: 888-245-0179
Monday-Friday 8 a.m. to 5 p.m.
Closed on State holidays.
 
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