CMS Pub. 100-06, ch. 1, § 120.1

A1-1215.1, B1-4215.1

A. General

The contractor shall use this schedule to identify specific other direct costs included in

the Other Direct Costs line of the Activity Screen as defined in §90.9 E. A separate

Schedule A is completed for each activity requiring the specific identification of Other

Direct Costs.

B. Uses

The contractor shall complete this schedule only with the concurrence of CMS. It may

not be required of all contractors. If required, the schedule may be used for the BR, SBR,

IER and/or FACP.

C. Explanation of Entries on the Schedule A

1. Code - A three-digit code identifying each cost item. The contractor shall use 999 to

identify all remaining costs not requiring specific identification.

2. Description - A brief description of the discrete cost item. Types of costs to be

reported are described in §90.9 E and may also include such items as consultant fees, cost

of money and travel depending on the nature of the contractor's contract. Those items

requiring identification will depend on contract needs, materiality and other

considerations. The classification of costs in the contractor's cost accounting system,

government regulations and the contract will determine whether the cost is classified as

an Other Direct Cost.

3. Total Cost - The contractor shall report the total cost for each item. The total for all

Other Direct Costs, including those reported under 999 if applicable, must agree with the

total reported on the Other Direct Costs line of the Activity Screen.

130 - Exhibit of Schedule of Other Costs (Schedule B) - (Rev. 1, 08-30-

02)

A1-1216, B1-4216

Click here to view exhibit of Schedule of Other Costs (Schedule B)

130.1 - Completing the Schedule of Other Costs (Schedule B) - (Rev. 1,

08-30-02)

A1-1216.1, B1-4216.1

A. General

The contractor shall use this schedule to identify specific other costs included in the

Other Costs line of the Activity Screen as defined in §90.9 F. A separate Schedule B is

completed for each activity requiring the specific identification of other costs.

B. Uses

The contractor shall complete this schedule only with the concurrence of CMS. It may

not be required of all contractors. If required, the schedule may be used for the BR, SBR,

IER and/or FACP.

C. Explanation of Entries on the Schedule B

1. Code - A three-digit code identifying each cost item. The contractor shall use 999 to

identify all remaining costs not requiring specific identification.

2. Description - A brief description of the discrete cost item. Types of costs to be

reported are described in §90.9 F. Those items requiring identification will depend on the

nature of the contractor's contract/agreement, materiality and other considerations. The

classification of costs in its cost accounting system, government regulations and the

contract/agreement will determine whether the cost is classified as an Other Cost.

3. Total Cost - The contractor shall report the total cost for each item. The total for all

Other Costs, including those reported under 999 if applicable, must agree with the total

reported on the Other Direct Costs line of the Activity Screen.

140 - Exhibit of Schedule of Non-COB Credits (Schedule C) - (Rev. 1,

08-30-02)

A1-1217, B1-4217

Click here to view exhibit of Schedule of Other Costs (Schedule C).