Instructions for Form DHS3095 Medi-Cal Home Office Cost Report - California

This document contains official instructions for Form DHS3095 , Medi-Cal Home Office Cost Report - a form released and collected by the California Department of Health Care Services.

FAQ

Q: What is Form DHS3095?A: Form DHS3095 is the Medi-Cal Home Office Cost Report for California.

Q: Who is required to file Form DHS3095?A: Providers of home health care services in California who participate in the Medi-Cal program are required to file Form DHS3095.

Q: What is the purpose of Form DHS3095?A: The purpose of Form DHS3095 is to report the home office costs incurred by providers of home health care services in California.

Q: What information is required on Form DHS3095?A: Form DHS3095 requires providers to report various expenses related to their home office, such as rent, utilities, and administrative costs.

Q: When is Form DHS3095 due?A: Form DHS3095 is due within 120 days after the close of the provider's fiscal year.

Q: Are there any penalties for late filing of Form DHS3095?A: Yes, providers may be subject to penalties for late filing of Form DHS3095, including the potential loss of reimbursement for the home office costs.

Q: Can I request an extension to file Form DHS3095?A: Yes, providers can request an extension to file Form DHS3095, but it must be submitted in writing to the DHCS.

Q: Who should I contact for assistance with Form DHS3095?A: For assistance with Form DHS3095, providers can contact the DHCS directly or consult with a certified public accountant (CPA) experienced in Medi-Cal reporting requirements.