US · guidance
CMS Pub. 100-04, ch. 4, § 10.11.3.2
Hospital or CMHC Request for Use of a Different CCR
Effective January 1, 2009, CMS (or the Medicare contractor) may specify an alternative
CCR if it believes that the CCR being applied is inaccurate. In addition, a hospital or
CMHC has the opportunity to request that a different CCR be applied for outlier payment
calculation in the event it believes the CCR being applied is inaccurate. The hospital or
CMHC is required to present substantial evidence supporting its request. Such evidence
should include documentation regarding its costs and charges that demonstrate its claim
that an alternative ratio is more accurate. After the Medicare contractor has evaluated the
evidence presented by the hospital or CMHC, the Medicare contractor notifies the CMS
central office and CMS regional office of any such request. The CMS central and
regional offices approve or deny any request by the hospital (or CMHC) or Medicare
contractor for use of a different CCR. Medicare contractors shall send requests to the
CMS central office using the address and e-mail address provided above.
History
(Rev. 1657, Issued: 12-31-08, Effective: 01-01-09, Implementation: 01-05-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
05e8d7218230bec44a43dcf11868569a35b062e6a88ac233a5fdaa8b84609031
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