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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, nonphysician 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:
Defining "Date of Filing"
For internet PECOS: the date we receive the two-page signed certification statement pages in our mailroom. Send this and other supporting paper documentation within seven days of electronic submission.
For paper applications: the date the entire (completed) application is received in our mailroom.
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.
Reference: MLN Matters® article MM6310 (PDF, 72 KB).
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Last Updated: 12/11/2020