The upcoming 2024 New York State Medicaid Ambulatory Health Care Facility (AHCF) cost report filing will play a critical role in determining Medicaid reimbursement for providers across the state. These reports are more than a routine compliance requirement; they are a cornerstone of how New York calculates and distributes Medicaid funding. Regardless of whether your facility operates as a Federally Qualified Health Center (FQHC) or as another type of Diagnostic & Treatment Center, the way the report is prepared can have a substantial financial impact on your organization.
Key Deadlines and Preparation
In a Dear Administrator Letter dated September 22, 2025, the Department of Health (DOH) announced that the 2024 AHCF cost report software was now available with a filing deadline of Monday, December 15, 2025. Therefore, now is the time to carefully review your facility’s trial balance and general ledger. Ensuring that expenses are properly categorized on Exhibit IIIA is not just good housekeeping — it is essential for protecting your reimbursement rates and ensuring alignment with DOH regulations.
Special Considerations for FQHCs
For FQHCs and FQHC LAL’S (look-alikes), reimbursed under the Prospective Payment System (PPS), the AHCF cost report is especially significant. Accurate allocation of costs to the correct cost centers (administration, medical, dental, etc.) is central to the PPS rate-setting process. This is particularly important for new FQHCs submitting a base year cost report, or for centers requesting a revised rate due to service expansions, Certificate of Need (CON) approved changes, or other updates. In these cases, the way costs are positioned within the report can materially influence your Medicaid reimbursement going forward.
Considerations for Non-FQHC Facilities
For non-FQHC facilities, reimbursed under the Ambulatory Patient Group (APG) system, the cost report plays a critical role in determining the facility’s capital rate. Expenses reported in the capital portion of Exhibit IIIA directly influence this calculation. Our team has had success in helping clients dig through costs, identify capital expenses, and properly reflect them in the report, resulting in stronger capital reimbursement.
How Our Team Can Help
Our firm’s dedicated Healthcare Consulting team has worked with facilities across New York State to delve into trial balances, general ledgers, and supporting documentation, ensuring both compliance with DOH regulations and optimization of reimbursement.
If you need further guidance or have any questions, we are here to help. Please do not hesitate to reach out to discuss your specific situation.
This material has been prepared for general, informational purposes only and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. Should you require any such advice, please contact us directly. The information contained herein does not create, and your review or use of the information does not constitute, an accountant-client relationship.
