Important Information on the Timely Claims Filing Requirement


All claims must be filed with your Medicare contractor no later than one calendar year (12 months) from the date of service or Medicare will deny them.

  • In general, the start date for determining the one year timely filing period is the date of service or "From" date on the claim. 
    • For institutional claims that include span dates of service (i.e., a "From" and "Through" date on the claim), the "Through" date on the claim is used for determining the date of service for claims filing timeliness
    • For claims submitted by physicians and other suppliers that include span dates of service, the line item "From" date is used for determining the date of service for claims filing timeliness
  • Medicare claims for which assignment was accepted must be filed within one year from the date of service
  • Whenever the last day for filing a claim timely falls on a Saturday, Sunday, federal non-workday or legal holiday, the claim will be considered timely if it is filed on the next workday

Note: The same time limit applies for filing Medicare secondary payer (MSP) claims. We strongly recommend that you file MSP claims timely, even if you do not expect Medicare to make additional payment (secondary) payment. 

References

  • CMS guidelines — time limitation for filing claims: CMS Pub. 100-04, Chapter 1, Section 70.3, 70.4, 70.6 (PDF, 1.56 MB)
    • Exceptions to time limit: section 70.7–70.7.3
  • Federal regulations (CFR 424.44): time limitation for filing claims at www.gpo.gov/fdsys/
  • MM6960 (PDF, 74 KB) — Systems Changes Necessary to Implement the Patient Protection and Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months
  • MM7080 (PDF, 78 KB) — Timely Claims Filing: Additional Instructions
  • MM7270 (PDF, 104 KB) — Changes to the Time Limits for Filing Medicare Fee-for-Service Claims




Last Updated: 01/08/2018