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Medicare's Electronic Cost Report Submission Process

By Amber Aubin .

Prior to 2019, the Centers for Medicare and Medicaid Services (“CMS”) released an application, MCReF (“the portal”), which allows a Medicare Administrative Contractor (“Provider”) to electronically transmit its Medicare cost report to CMS. This is the only way to electronically file a cost report with CMS. If you intend to use this portal, or ran into problems in the setup of the portal and still need to complete the setup process, the following is a list of tips to help you get started:


Some of you may have already set up a login to this portal last year. If so, you should ensure you can still login with your username and password that you used last year. 

Access to the portal is restricted to the Provider Statistical and Reimbursement (“PS&R”) System Security Official and Backup Security Official. In simpler terms, if someone already has access to download a PS&R report, then access is already granted to the portal. If you have never accessed the PS&R report, then you will need to register a security official with the Enterprise Identity Management (“EIDM”) System and request access to the portal. This process can take up to four weeks.

Helpful tip – when registering a security official you should enter the name of the Provider you are registering exactly as it appears on an IRS issued form/document (such as the Provider’s EIN) with all commas and periods, otherwise access may be denied.


If you already have access to the PS&R report, the login will be the same username and password used to obtain the PS&R report. Once a security official is set up within the EIDM system, the security official can log in with the credentials used to set up the account at


The upload process has been simplified so that files will not need to be mailed to the Medicare Fiscal Intermediary, as long as the portal is utilized and electronic signatures are enabled. To electronically sign the cost report: make sure the checkbox on Worksheet S is checked; apply a signature; and, upload a scanned copy to the portal, along with all other required files. Once the upload is complete, an instant notification of receipt will be emailed to you.

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