US · guidance
CMS Pub. 100-06, ch. 6, § 70.12
Checking Reports
A3-3898.12
Before submitting Form Q to CMS, check for completeness and arithmetical accuracy.
Use the following checklist:
• For all columns, line 1 + line 2 - line 3 = line 4.
• For all lines, column 1 + column 2 + column 3 = column 4.
History
(Rev. 6, 08-30-02)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
d03fb0946323727a8d7001bce463bf690fe5b7a0a17367a1c2edccdbc829bb8a
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