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The Centers for Medicare & Medicaid Services (CMS) strongly encourages Medicare providers to submit cost reports electronically using the Medicare Cost Report e-Filing (MCReF) system. Electronic filing improves submission accuracy, reduces processing delays, and provides confirmation of timely filing—critical for avoiding payment suspension.
Related: If your filing is late or rejected, visit our Late / Rejected Cost Reports page for immediate guidance and support.
Instructions for
Uploading Medicare Cost Reports via MCReF
This PPS-created, one-page white paper provides step-by-step instructions for
uploading Full, Low
Utilization (LU), and No Utilization (NU) Medicare cost reports
through MCReF. Includes screenshots, common filing tips, and guidance designed
to reduce rejections and delays.
Ideal for providers seeking
a fast, practical MCReF filing reference.
CMS Tool – Filing via
MCReF: Step-by-Step Guide
CMS’s official resource for MCReF registration and electronic cost report
submission. This guide includes screenshots and detailed instructions for
setting up access, uploading files, and confirming successful submission.
https://www.cms.gov/medicare/audits-compliance/part-a-cost-report/medicare-cost-report-electronic-filing-mcref
How to Access and Use
MCReF Through the CMS EIDM System
This short video explains how Medicare Part A providers obtain access to MCReF
using the CMS Enterprise Identity Management (EIDM) system. It also covers role
delegation for staff and consultants who assist with cost report filing.
How to File Medicare
Cost Reports Using MCReF
This step-by-step video walkthrough demonstrates how to upload Medicare cost
reports and supporting documentation in MCReF, helping providers understand
required screens, validation steps, and final submission.
CMS Medicare Cost
Report Electronic Filing (MCReF)
CMS’s primary landing page for Medicare cost report electronic filing
requirements, system updates, and compliance guidance.
Use this checklist to help ensure a successful MCReF submission and avoid late or rejected cost reports:
☐ Confirm your
cost report due date
with your MAC
☐ Verify EIDM access and MCReF
user roles are active
☐ Prepare the
correct Electronic Cost
Report (ECR) files
☐ Assemble all
required supporting
documentation
☐ Review
signature requirements and electronic
signature designation
☐ Upload files to
MCReF and verify successful
transmission
☐ Confirm the electronic postmark
(must be completed by 11:59 PM ET on the due date)
☐ Save MCReF
confirmation for your records
If your upload fails, validation errors occur, or the report is rejected, act immediately to avoid payment suspension.
If your Medicare cost report is late,
rejected, or at risk, visit our
Late / Rejected Cost
Reports page to understand the consequences and learn how PPS
can help you resolve filing issues quickly and minimize financial disruption.
