Reason Code 39011

The claim was not submitted timely. Medicare regulations require claims to be submitted within one year of the date of service (through "To" date of service on the claim).

The timely filing period for both paper and electronic Medicare claims is no later than one calendar year after the date of service.

Please refer to the Timely Filing Job Aid (JJA, JMA) and What is the timeframe for submitting a claim adjustment? (JJA, JMA). Further information is available on the CMS IOM 100-4, chapter 34 (PDF, 97 KB) — Reopening and Revision of Claim Determinations and Decisions.

Note: If claim is not timely, a Reopening Adjustment (XXQ) type of bill may be applicable. Please see CMS MLN Matters MM8581 (PDF, 84 KB) or CMS MLN Special Edition SE1426 (PDF, 1 MB) for further guidance.

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