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January 25, 2018


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Medical Coding News Archives

Timely Filing Requirements for Medicare Fee-for-Service Claims

 
May 13, 2010:

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. The law amends the timely filing requirements by reducing the maximum time period for submission of all Medicare FFS claims to one calendar year from the date of service.

Under the new law, claims for services furnished on or after January 1, 2010, must be filed within one calendar year following the date services were rendered. In addition, section 6404 mandates that claims for services furnished before January 1, 2010, must be submitted no later than December 31, 2010. Claims with dates of service prior to October 1, 2009, must follow the pre-PPACA timely filing rules; however, claims for dates of service beginning October 1, 2009, through December 31, 2009, must be filed by December 31, 2010.

Section 6404 of the PPACA also permits the secretary of the Department of Health and Human Services to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established. However, proposals for exceptions will be specified in future proposed rule making.

Deborah C. Hall

Clinical/Technical Editor

Key Terms: Timely Filing

 

 
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