Federally Qualified Health Center Cost Report Form (CMS-224-14)

OMB 0938-1298

OMB 0938-1298

Providers of services participating in the Medicare program are required under sections 1815(a) and 1861(v)(1)(A) of the Act (42 U.S.C. 1395g) to submit annual information to achieve settlement of costs for health care services rendered to Medicare beneficiaries. In addition, regulations at 42 CFR 413.20 and 413.24 require adequate cost data and cost reports from providers on an annual basis. The form CMS-224-14 cost report is needed to determine a provider's reasonable costs incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider.

The latest form for Federally Qualified Health Center Cost Report Form (CMS-224-14) expires 2022-03-31 and can be found here.


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