© 2021 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
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)
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 01/05/2018