Medicare Claims Filing Deadline is 1 Year Now

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program.

The time period for filing Medicare FFS claims is specified in Sections 1814(a), 1835(a)(1), and 1842(b)(3) of the Social Security Act and in the Code of Federal Regulations (CFR), 42 CFR Section 424.44. Section 6404 of the PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to ONE calendar year after the date of service.

The following rules apply:

Date of Claim Deadline to Submit
On or after Jan. 1, 2010 Within one calendar year after the date of service
Before Jan. 1, 2010  Dec. 31, 2010
  • Before Oct. 1, 2009
Follow pre-PPACA timely filing rules*
  • Oct. 1, 2009, through Dec. 31, 2009
Dec. 31, 2010. 

* Under pre-PPACA rules, Medicare carries can accept claims for dates of service from Oct. 1, 2008, through Sept. 30, 2009. Claims filed beyond one year of the service date will be automatically reduced by 10%.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: