Where to locate total patient revenue on your Medicare Cost Report

Total patient revenue appears in Worksheet S, Part I of the Medicare Cost Report (also called the CMS-2552-10 form). This worksheet breaks down all revenue your facility received from patients, organized by payer type — Medicare, Medicaid, commercial insurance, and self-pay. The line you're looking for is typically labeled "Total Patient Revenue" and represents the sum of all patient-related income before deductions or adjustments.

The exact location depends on your facility type. Hospitals report on a different version of the form than skilled nursing facilities or home health agencies, so the worksheet numbers and line items shift. The Medicare Cost Report instructions (published annually by CMS) specify which worksheet applies to your organization type, and that document is your most reliable reference for the exact line number in your version.

If you're reviewing a cost report that's already been filed, you can find it through the CMS Hospital Compare website (now part of Care Compare) or by requesting it directly from the facility. Facilities are required to make their cost reports available to the public, though response times vary.

Key Takeaways

  • Total patient revenue is found in Worksheet S, Part I of the Medicare Cost Report, though the exact line number varies by facility type.
  • The worksheet separates revenue by payer source — Medicare, Medicaid, commercial, and self-pay — so you can see which payers contributed most to total revenue.
  • The Medicare Cost Report instructions published by CMS each year specify the correct worksheet and line number for your facility's organization type.
  • Completed cost reports are public documents; you can request them from the facility or search for hospitals through the CMS Care Compare database.

Why total patient revenue matters on the cost report

Total patient revenue is the foundation for understanding how much money a facility brought in from patient care. Medicare uses this figure to calculate reimbursement rates, assess financial performance, and determine whether a facility is operating sustainably. For researchers, regulators, and people evaluating a facility's financial health, this number answers a basic question: how much did patients (through their insurance or out of pocket) actually pay?

The revenue figure also helps explain the relationship between what Medicare pays and what the facility's total income was. A facility might receive a certain amount from Medicare, but total patient revenue shows the complete picture — including what Medicaid paid, what commercial insurers paid, and what uninsured patients paid directly. This context matters when comparing facilities or understanding why a facility's financial situation changed year to year.

How to read Worksheet S and understand the breakdown

Worksheet S is divided into parts, with Part I showing revenue by payer type. You'll typically see separate lines for Medicare inpatient revenue, Medicare outpatient revenue, Medicaid revenue, commercial insurance revenue, and self-pay revenue. Each line shows the gross charges (what was billed) and the actual revenue received (what was collected after contractual adjustments and denials).

The distinction between gross charges and net revenue is important. Gross charges are the full amount billed; net revenue is what the facility actually received. Insurance contracts often include negotiated discounts, so the amount billed to Medicare may be higher than the amount Medicare actually paid. Worksheet S shows both figures so you can see the gap between what was charged and what was collected.

Below the payer-specific lines, you'll find the total patient revenue line, which adds up all the net revenue from all payers. This is the number most people are looking for when they ask about "total patient revenue."

Differences between facility types and their cost report versions

Hospitals file the CMS-2552-10 form, which is the most detailed version. Skilled nursing facilities file a different version with different worksheets. Home health agencies, hospices, and other provider types each have their own cost report format. The worksheet numbers and line item descriptions are not interchangeable across these forms.

If you're looking at a cost report and the worksheet numbers don't match what you've read elsewhere, check the cover page of the form to confirm the facility type and the form version. The instructions document for that specific form will have the correct line numbers. CMS publishes updated instructions each year, so an older cost report may use slightly different line numbers than a current one.

How to access cost reports online and in person

The easiest starting point is the CMS Care Compare website (care.cms.gov), which includes a searchable database of hospitals and some other facility types. You can search by facility name or location, and many facilities have cost report data linked from their profile page. Not all facility types are included in Care Compare, so this method works best for hospitals.

If Care Compare doesn't have the facility or the year you need, contact the facility's finance or compliance department directly and request a copy of the cost report. Facilities are required by law to provide this information within a reasonable timeframe, though "reasonable" is not strictly defined and can range from a few days to several weeks depending on the facility's size and staffing.

Some state health departments also maintain archives of cost reports filed within their state. Calling your state's department of health or department of insurance can point you toward their database, if one exists. A few states make cost reports publicly searchable online; others require an in-person request or a formal records request.

Understanding the Medicare Cost Report instructions

CMS publishes a new version of the Medicare Cost Report instructions every year, usually in the fall. These instructions are free and available on the CMS website under "Cost Reports." The instructions document for your facility type is essential reading if you need to find a specific line item, because it explains what each worksheet covers and which lines go where.

The instructions are written for facility accountants and billing staff, so the language is technical. However, the section on Worksheet S is usually clearer than other parts, and the line-by-line descriptions tell you exactly what revenue should be reported on each line. If you're unsure whether a particular line is what you're looking for, the instructions will clarify it.

You can also contact your facility's billing or finance department and ask them to point you to the specific line on their most recent cost report. Most facilities have staff who work with cost reports regularly and can answer this question quickly.

Common reasons the total revenue figure changes year to year

Total patient revenue can shift for several reasons: a change in patient volume, a change in payer mix (more Medicare patients, fewer commercial patients, for example), a change in negotiated rates with insurance companies, or a change in the facility's service offerings. A facility that added a new outpatient service line or expanded its emergency department might see total revenue increase even if the number of patients stayed the same.

Conversely, if a facility's total revenue dropped significantly, it could signal a decline in patient volume, a loss of a major contract with an insurance company, or an increase in uninsured or underinsured patients. The cost report alone won't tell you which factor caused the change, but comparing the revenue breakdown across payers (Medicare, Medicaid, commercial, self-pay) from year to year can point you toward the likely cause.

Frequently Asked Questions

Is total patient revenue the same as total facility revenue?

No. Total patient revenue is money from patient care only. Facilities also receive revenue from other sources — grants, donations, investment income, cafeteria sales, parking fees, and other non-patient services. The Medicare Cost Report focuses on patient revenue, so total patient revenue will be lower than the facility's actual total revenue.

Can I compare total patient revenue between two different hospitals?

You can compare the numbers, but the comparison is most meaningful when you also look at patient volume, case mix (how sick the patients are), and geographic location. A large urban hospital will have higher total patient revenue than a small rural hospital, but that doesn't mean it's more efficient or better-run. Dividing total patient revenue by the number of patient days or admissions gives you a revenue-per-patient figure that's easier to compare across facilities.

How recent is the cost report data I find online?

Cost reports are filed annually, usually several months after the facility's fiscal year ends. A hospital with a calendar-year fiscal year files its cost report by late spring or early summer of the following year. The data you find online may be one to two years old, depending on when you're looking and how quickly the facility filed. Check the report's cover page for the fiscal year it covers.

What if the facility I'm looking for doesn't have a cost report available online?

Smaller facilities, rural facilities, and some specialty providers may not appear in the CMS Care Compare database. Contact the facility directly or try your state health department's records office. If the facility is part of a larger health system, the system's main office may have centralized records and can direct you to the right department.

Does total patient revenue include bad debt or charity care?

No. Total patient revenue on Worksheet S includes only money actually collected from patients or their payers. Bad debt (bills written off because they couldn't be collected) and charity care (care provided for free to uninsured patients) are reported separately on other worksheets. This is why total patient revenue is lower than total charges — the difference includes contractual adjustments, denials, bad debt, and charity care.