Questions billers ask › What is the Medicare timely filing limit for nursing home claims?
What is the Medicare timely filing limit for nursing home claims?
The rule, word for word
“(a) Time limits. (1) Except as provided in paragraphs (b) and (e) of this section, for services furnished on or after January 1, 2010, the claim must be filed no later than the close of the period ending 1 calendar year after the date of service. (2) Except as provided in paragraphs (b) and (e) of this section and except for services furnished during the last 3 months of 2009, for services furnished before January 1, 2010, the claim must be filed— (i) On or before December 31 of the following year for services that were furnished during the first 9 months of a calendar year; and (ii) On or before December 31st of the second following year for services that were furnished during the last 3 months of the calendar year. (3) For services furnished during the last 3 months of CY 2009 all claims must be filed no later than December 31, 2010. (b) Exceptions to time limits. Exceptions to the time limits for filing claims include the following: (1) The time for filing a claim will be extended if CMS or one of its contractors determines that a failure to meet the deadline in paragraph (a) of this section was caused by error or misrepresentation of an employee, Medicare contractor (including Medicare Administrative Contractor, intermediary, or carrier), or agent of HHS that was performing Medicare functions and acting within the scope of its authority. (2) The time for filing a claim [...]”
Published2026-04-06 Captured2026-04-06
sha256:f01cbb65…eb3e9e56 · Source
What our AI found in the sources
For services furnished on or after January 1, 2010, nursing homes (and all other Medicare providers and suppliers) must file claims no later than 1 calendar year after the date of service. Several exceptions can extend this deadline, including CMS contractor error, retroactive Medicare entitlement, or recovery of Medicaid payment 6 months or more after service.
Also cited
Captured2026-05-24
sha256:1ee358b6…15f32bf5 · Source
If this comes up on one of your claims
The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.
Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.
Ask Verbatim your question