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Medicare Timely Filing for Span Date Claims

Published on 

Thursday, August 19, 2010

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CMS Transmittal 734 (CR 7080) clarifies the new Medicare timely filing limits regarding line item span dates and leap years.  The Affordable Care Act (ACA) changed the timely filing limit to 1 calendar year after the date of service (DOS) for services furnished on or after January 1, 2010.  Claims for services furnished prior to January 1, 2010 must be filed no later than December 31, 2010.

For institutional claims that include span dates of service (i.e., a “From” and “Through” date span on the claim), the “Through” date on the claim will be used to determine the date of service for claims filing timeliness.  Timeliness will be determined by the “From” date for professional claims (CMS-1500 Form and 837P).

Claims with a date of service of February 29th must be filed by February 28th of the following year to be considered as timely filed.  Claims received on or after March 1st of the following year will be denied for having failed the timely filing limit.

For more information, see the Transmittal at the link above or MLN Matters Article M7080.

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This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.