All acute inpatient facilities must complete this report any week where there are Wyoming Medicaid members admitted, resident, or discharged.

NOTE: If you do not have any patients to report you DO NOT need to submit a census report (Policy update 7/1/22)

It must be submitted by 5:00pm on Friday of each week.

If Friday is not a working day, the ICR must be submitted by 5:00pm the previous working day.

This form will allow you to submit up to 25 members. If you have additional members to report, you'll have to fill out a new form.