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Printed Date: 9/22/2015
The determination of a provider’s effective date for billing Medicare claims is based upon the date an application is received from the following physicians, non-physician practitioners (NPPs) and organizations.
In accordance with 42 CFR §424.520(d), the effective date for the individuals and organizations identified above is the later of either:
Note: The date of filing means:
For Internet PECOS
For paper applications
In regard to billing Medicare claims, the individuals and organizations identified above may retrospectively bill for services dated up to 30 days prior to their effective date when the supplier has met all program requirements, including state licensure requirements and providing that the services were provided at the enrolled practice location.
MLN Matters® article MM6310 (PDF, 72 KB)
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Last Updated: 01/05/2018