CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM (parts 405 to 426) > PART 424—CONDITIONS FOR MEDICARE PAYMENT > SUBPART P—Requirements for Establishing and Maintaining Medicare Billing Privileges (§424.500 to §424.565) > 424.521—Request for payment by physicians, nonphysician practitioners, physician or nonphysician organizations.

424.521—Request for payment by physicians, nonphysician practitioners, physician or nonphysician organizations.

(a) Physicians, nonphysician practitioners and physician and nonphysician practitioner organizations may retrospectively bill for services when a physician or nonphysician practitioner or a physician or a nonphysician organization have met all program requirements, including State licensure requirements, and services were provided at the enrolled practice location for up to—
(1) 30 days prior to their effective date if circumstances precluded enrollment in advance of providing services to Medicare beneficiaries, or
(2) 90 days prior to their effective date if a Presidentially-declared disaster under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-520 6 (Stafford Act) precluded enrollment in advance of providing services to Medicare beneficiaries.
(b) [Reserved]
[73 FR 69940, Nov. 19, 2008]