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US · guidance

CMS Pub. 100-16, ch. mc86c16a, § 120

Timely Filing Requirement

activein force · 2026-08-25 – presentas-observed

For services furnished on or after January 1, 2010, deemed and non-contracting providers

furnishing services to PFFS plan members must submit a claim to the plan for an Original

Medicare-covered service within the same time frame the provider would have to submit

under Original Medicare, which is within 1 calendar year after the date of service

The rules for submitting timely claims under Original Medicare can be found at

https://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf.

History

(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b8611c1512a90cc7d514ac17419a6b1d36ede58061762b38f2daf487ec816b09
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