HFMA CSAF Certification Exam Review
2026: Comprehensive Practice Exam &
Answer Key
SECTION 1: Financial Reporting
1. Net Patient Service Revenue
A hospital reports:
• Gross patient revenue: $120,000,000
• Contractual allowances: $42,000,000
• Bad debt expense: $6,000,000
What is Net Patient Service Revenue?
Answer: $72,000,000
Solution:
120,000,000 − 42,000,000 − 6,000,000 = 72,000,000
2. Operating Income
Operating revenue = $95,000,000
Operating expenses = $90,250,000
What is operating income?
Answer: $4,750,000
Solution:
95,000,000 − 90,250,000
3. Non-Operating Revenue
Which item is classified as non-operating revenue?
,A. Patient service revenue
B. Cafeteria sales
C. Investment income
D. Pharmacy revenue
Answer: C. Investment income
4. Statement of Cash Flows
Depreciation expense appears in which section?
Answer: Operating activities (non-cash adjustment)
5. Balance Sheet
Accounts receivable is classified as:
Answer: Current asset
SECTION 2: Budgeting & Forecasting
6. Flexible Budget
Budgeted volume = 18,000 visits
Actual volume = 21,000 visits
Cost per visit = $275
Flexible budget amount?
Answer: $5,775,000
Solution:
21,000 × 275
7. Capital Budget
Which item belongs in a capital budget?
, A. Staff overtime
B. Medical supplies
C. MRI purchase
D. Utilities
Answer: C. MRI purchase
8. Zero-Based Budgeting
Zero-based budgeting requires:
Answer: All expenses to be justified from zero each period
9. Variance Analysis
Actual expenses exceed budget. This is a:
Answer: Unfavorable variance
10. Rolling Forecast
A rolling forecast updates projections:
Answer: Continuously throughout the year
SECTION 3: Cost Accounting
11. Cost Behavior
Which cost is fixed?
A. Medical supplies
B. Nursing labor (hourly)
C. Building depreciation
D. Per-test lab reagents
Answer: C. Building depreciation
2026: Comprehensive Practice Exam &
Answer Key
SECTION 1: Financial Reporting
1. Net Patient Service Revenue
A hospital reports:
• Gross patient revenue: $120,000,000
• Contractual allowances: $42,000,000
• Bad debt expense: $6,000,000
What is Net Patient Service Revenue?
Answer: $72,000,000
Solution:
120,000,000 − 42,000,000 − 6,000,000 = 72,000,000
2. Operating Income
Operating revenue = $95,000,000
Operating expenses = $90,250,000
What is operating income?
Answer: $4,750,000
Solution:
95,000,000 − 90,250,000
3. Non-Operating Revenue
Which item is classified as non-operating revenue?
,A. Patient service revenue
B. Cafeteria sales
C. Investment income
D. Pharmacy revenue
Answer: C. Investment income
4. Statement of Cash Flows
Depreciation expense appears in which section?
Answer: Operating activities (non-cash adjustment)
5. Balance Sheet
Accounts receivable is classified as:
Answer: Current asset
SECTION 2: Budgeting & Forecasting
6. Flexible Budget
Budgeted volume = 18,000 visits
Actual volume = 21,000 visits
Cost per visit = $275
Flexible budget amount?
Answer: $5,775,000
Solution:
21,000 × 275
7. Capital Budget
Which item belongs in a capital budget?
, A. Staff overtime
B. Medical supplies
C. MRI purchase
D. Utilities
Answer: C. MRI purchase
8. Zero-Based Budgeting
Zero-based budgeting requires:
Answer: All expenses to be justified from zero each period
9. Variance Analysis
Actual expenses exceed budget. This is a:
Answer: Unfavorable variance
10. Rolling Forecast
A rolling forecast updates projections:
Answer: Continuously throughout the year
SECTION 3: Cost Accounting
11. Cost Behavior
Which cost is fixed?
A. Medical supplies
B. Nursing labor (hourly)
C. Building depreciation
D. Per-test lab reagents
Answer: C. Building depreciation
