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What is a timely filing limit for Medicare?

what is the timely filing limit for medicare

Deb Willoughby

Answered Most Recently

Medicare law prescribes specific time limits for providers to follow when submitting claims for Part B Medicare services. Claims must be filed no later than the end of the calendar year following the year in which the services were provided. However, the filing limit is extended another full year if the service was provided during the last three months of the year.

Whenever the last day for timely filing of a claim falls on a Saturday, Sunday, federal non-workday or legal holiday, the claim will be considered filed timely if it is filed on the next workday.

Claims filed

later than the filing limit will be denied. Providers may only collect the normal coinsurance that would have applied, as well as any unmet deductible, from the beneficiary.

Medicare assigned claims filed more than one year from the service date, payment will be reduced by 10 percent. The 10 percent reduction cannot be billed to the patient. [MCM 3004.A]

Timely Submission of Claims

Medicare claims must be submitted within the following time limits:

For services provided between: The claim must be submitted by:

October 1, 2007 and September 30, 2008 December 31, 2009

October 1, 2008 and September 30, 2009 December 31, 2010

Category: Insurance

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