New timely filing requirements for Medicare fee-for-service claims
Section 6404 of the Patient Protection and Affordable Care Act (the Act) amended the timely filing requirements to reduce the maximum time period for submission of all Medicare fee-for-service claims to one calendar year after the date of service.
Under the Act, claims for services furnished on or after Jan. 1, 2010, must be filed within one calendar year after the date of service. In addition, Section 6404 mandates that claims for services furnished before Jan. 1, 2010, must be filed no later than Dec. 31, 2010.
According to CMS, the following rules apply to claims with dates of service prior to Jan. 1, 2010:
- Claims with dates of service before Oct. 1, 2009, must follow the pre-Act timely filing rules.
- Claims with dates of service Oct. 1, 2009 through Dec. 1, 2009, must be submitted by Dec. 1, 2010.
Section 6404 of the Act also permits the Secretary of the U.S. Department of Health and Human Services to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established.
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