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Wisconsin Department of Health Services

Wisconsin Department of Health Services

Medicaid Cost Reports are considered to be public information. Cost Reports submitted in 2014 or later can be publicly accessed on this website by clicking on the section below. To obtain copies of Cost Reports for years prior to 2014, please follow the process described on the DMS website.

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Important Contact Information
Address:
Myers and Stauffer LC
150 Flynn Avenue, Suite 200
Frankfort, KY 40601

Phone: 502.695.6870
Toll Free Phone: 888.749.5799
Fax: 502.695.3068

Wisconsin Nursing Home Rate Setting (WINHRS) Questions:
Help Desk Phone: 800.763.2278
Help Desk Email: WINHRSHelpDesk@mslc.com

Publicly Available Cost Reports

Wisconsin Department of Health Services makes provider submitted cost reports publicly available.
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Family Care MCO Rates by RUG/PDPM Category

The Family Care MCO rates spreadsheets display nursing facility PDPM rates by Nursing and NTA category for use by Family Care MCOs. The spreadsheets provide rates by state fiscal year, going back seven years. Each file may contain listings of interim and final rates along with multiple rate effective dates. Prior to January 1, 2022, RUG-IV (48 cell) rates were included. Effective January 1, 2022, the spreadsheets will provide rates for each PDPM Nursing and NTA category.

The current state fiscal year spreadsheet is updated monthly, around the 3rd business day of each month, until FFS rate setting is complete for that rate year.  If you have questions regarding the spreadsheet or rates, please contact your nursing home’s assigned auditor.  Contact information for the WI Department of Health Services’ Nursing Home Policy and Rate Setting Section is available here.

GO TO MCO RATES

Patient-Driven Payment Model (PDPM) Billing Guidance

Patient-driven payment model (PDPM) billing guidance in a topical format relating to minimum data set assessments is available. This document describes policies for applying assessments to dates of service and generating valid Health Insurance Prospective Payment System (HIPPS) codes.

HIPPS codes will be required for non-developmentally disabled inhouse nursing home per diem claims billed to Medicaid fee-for-service for dates of service on and after January 1, 2022.  This document has also been posted on DHS’ website at https://www.dhs.wisconsin.gov/nh-rates/resources.htm.

GO TO PDPM BILLING GUIDANCE

Cost Report Templates

A current version of the Wisconsin Medicaid Nursing Facility Cost Report Template is now available.

Notable Changes from the 2024 Template:

  • Updated instructions for Schedules 1, 2, 4, 8, 13, 20, 26b, 34, 43, 50, 53.
  • Checklist logic updated for Schedule 53 to indicate an error if lines 1 or 2 are filled out and line 3 is blank.
  • Auditor phone numbers updated on the CR instructions.                                                
  • Schedule 43, line 5, previously for television, etc. was removed and the list re-numbered to account for the removal.   
  • Locked Line 2 description on Sch. 26b to be Salaries. 
  • Locked Line 1 description on Sch. 26ATT to be Audited Financial Statement Preparation.

GO TO COST REPORT TEMPLATES

Cost Report Template 2024 V002