Va. Admin. Code tit. 12, agency 30, ch. 70, pt. V, art. 3, form FORMS (12VAC30-70)
Computation of Inpatient Operating Cost, HCFA-2552-92 D-1 (12/92).
Apportionment of Cost of Services Rendered by Interns and Residents, HCFA-2552-92 D-2 (12/92).
Cost Reporting Forms for Hospitals (Map 783 Series), eff. 10/15/93
Certification by Officer or Administrator of Provider
Analysis of Interim Payments for Title XIX Services
Computation of Title XIX Ratio of Cost to Charges
Computation of Inpatient and Outpatient Ancillary Service Costs
Computation of Outpatient Capital Reduction
Computation of Title XIX Outpatient Costs
Computation of Charges for Lower of Cost or Charge Comparison
Computation of Title XIX Reimbursement Settlement
Computation of Net Medicaid Inpatient Operating Cost Adjustment
Calculation of Medicaid Inpatient Profit Incentive for Hospitals
Plant Costs
Education Costs
Obstetrical Care Requirements Certification
Computation for Separating the Allowable Plant and Education Cost (pass-throughs) from the Inpatient Medicaid Hospital Costs
Cost Reporting Form Residential Treatment Facilities, RTF-608 (undated, filed 9/2016)
Graduate Medical Education Application (eff. 8/2019)
Va. Admin. Code tit. 12, agency 30, ch. 70, pt. V, art. 3, form FORMS (12VAC30-70)
Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.