How is the Medicare effective date determined?
On April 1, 2009 the CMS implemented the final rule for establishment of effective billing dates for physicians and non-physicians via change request (CR) 6310. The new rule restricts the timeframe for submitting claims for retrospective payment. Specifically, establishment of effective billing dates for physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives; clinical social workers; clinical psychologists; registered dietitians or nutrition professionals; and physician and non-physician practitioner organizations (e.g., group practices) consisting of any of the categories of individuals previously identified is the later of: • The date of filing of a Medicare enrollment application that is able to be processed to approval. The date of filing for paper applications is the date the contractor receives a signed application. The date of filing for Internet-based PECOS applications is the date the
