224-14 FQHC Transmittals
The Medicare Cost Report changes frequently. Health Financial Systems keeps users informed in several different ways; e-mails, live web-ex sessions, news blogs, user meetings and our website. This page gives information about the details of such transmittals.


224-14 Approval Letter
224-14 T-2 from CMS Website

FQHC Transmittal 2

The FQHC, 224-14 system was updated to Transmittal 2 by CMS, on March 9, 2018. Transmittal 2 is effective for cost reporting periods ending on or after December 31, 2017. HFS was approved for Transmittal 2 on April 17, 2018 and the software has been released. The primary change in Transmittal 2 was the incorporation of a Worksheet S, check box to the certification and settlement summary statement for electronic signature submission to the FQHC cost reporting forms. This provision is available as an option for cost reporting periods ending on or after 12/31/2017 in accordance with 42 CFR 413.24(f)(4)(iv).

For additional information regarding the new HFS feature incorporating the electronic signature click here.

Other Transmittal 2 changes include:

  • Added Worksheet S-1, Part I, line 28 to indicate a FQHC facility that utilizes contract labor to provide medical and/or mental health services to its patients.
  • Added Worksheet S-1, Part II, line 16 to indicate a FQHC sub facility that utilizes contract labor to provide medical and/or mental health services to its patients.
  • Modified the instructions Worksheet S-3, Part I to include visits for Transitional Care Management (TCM) services as a medical visit if it is the only medical service provided on that day and it meets the TCM billing requirements.



FQHC Transmittal 1

On April 22, 2016, CMS published the new FQHC Cost Report, Form CMS-224-14. The new form CMS-224-14 will be effective for cost reporting periods beginning on or after October 1, 2014. This effective date reflects the implementation date of the new FQHC PPS, required under the Affordable Care Act.

CMS has also issued an extension for the filing of impacted FQHC reports. Following is a table of scheduled due dates by cost report period ending:

Cost Reporting Periods Beginning On or After October 1, 2014 and Ending on or Before: Original Due Date Revised Due Date Extension
09/30/2015 02/29/2016 07/31/2016 153 days
10/01/2015 through 10/31/2015 03/31/2016 07/31/2016 122 days
11/01/2015 through 11/30/2015 04/30/2016 07/31/2016 92 days
12/01/2015 through 12/31/2015 05/31/2016 08/31/2016 92 days
01/01/2016 through 01/31/2016 06/30/2016 08/31/2016 62 days
02/01/2016 through 02/29/2016 07/31/2016 08/31/2016 31 days
03/01/2016 through 03/31/2016 08/31/2016 08/31/2016 0 days

HFS was approved for Transmittal 1 on April 22, 2016, and the update was made available to the FQHC cost report users on April 29, 2016. Please note that if you used the HFS beta system to start 224-14 cost reports, any data entered into the beta system will be retained when you open the .mcrx file in the complete approved version of the software.

HFS has been approved