CMS: Medicare Claims Must Be Submitted Within 12 Months of Date of Service

Changes mandated by the Patient Protection and Affordable Care Act will require all Medicare fee-for-service claims to be submitted within 12 months (one calendar year) of the date of service in order to receive reimbursement, according to an MLN Matters article.

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Claims with dates of service on or after Jan. 1, 2010 received after 12 months will be denied by Medicare, according to the report.

The Centers for Medicare and Medicaid Services provided the following details regarding the change:

  • Claims with dates of service prior to Oct. 1, 2009 will be subject to pre-PPACA timely filing rules and associated edits;
  • Claims with dates of service Oct. 1, 2009 through Dec. 31, 2009 received after Dec. 31, 2010 will be denied as being past the timely filing deadline; and
  • Claims with dates of service Jan. 1, 2010 and later received more than one calendar year beyond the date of service will be denied as being past the timely filing deadline.

Read the MLN Matters article on Medicare fee-for-service claims (pdf).

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