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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_Full_cost_report_via_MCReF.pdf
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.
How to Access and Use MCReF Through the CMS EIDM System
NGS's initial video which 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. See also CMS's instructions on defining a dedicated MCReF User Role.
How to Use the Medicare Cost Report e-Filing System (MCReF)
This initial 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. Note that many changes have been made to the CMS MCReF system since this video was first recorded. See new CMS webinars below.
How to Sign in to MCReF/ PS&R
This PDF file explains how Medicare Part A providers sign in to MCReF
using the CMS Enterprise Identity Management (EIDM) system. It explains the difference between the prior sign-in experience and the new sign in experience.
How to File Medicare Cost Reports Using MCReF
CMS webinar on E-Filing cost reports, includes the one-click PS&R download. See also this link to the Power Point Presentation.
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.
