Calculating Eligible Expenses and Lost Revenue: When reporting on lost revenues, how should Reporting Entities treat “contractual adjustments from all third party payers” and “charity care adjustments” when determining patient care-related revenue sources?

Patient care-related revenue should be reported net of adjustments for all third party payers, charity care adjustments, bad debt, and any other discounts or adjustments, as applicable when reporting patient care-related revenue sources. For example, if a provider’s gross patient revenue was $5,000, and the contractual adjustment from the third-party payer or charity care adjustments was $3,000, the provider should report on the PRF report $2,000 in patient care-related revenue.

(Updated 8/30/2021)