Personal Care Services Cost Report
Cost Report forms and instructions can be found at www.nj.gov/humanservices/dds
The forms are Excel spreadsheets. While you must complete the entire Cost Report, you will only be required to submit Schedule A1, A2 and Schedule C1 (columns a, b, c, d, e, f, g) to the Division. You will also only be expected to provide information on the costs and expenditures for “personal care assistant services as described in N.J.A.C. 10:60-3.3.” – which are Medicaid PCA Services.
Cost Reports are due no later than June 1, 2015 The three schedules listed above, together with the completed Cost Report Cover Page should be e-mailed, in EXCEL FORMAT ONLY, to: AnnaMarie.Treglia@dhs.state.nj.us.
Should you have questions, please contact AnnaMarie Treglia at (609) 631-2486.
