Medicare Advantage (MA) Split-Year Claim Submission

MA Outpatient, Professional Claims and Critical Access Hospital (CAH) Swing Bed

For MA 2024-2025 outpatient, professional and CAH swing bed claims with charges incurred during different years, the charges must be submitted on separate claims. 

For example:
If dates of service are from Dec. 15, 2024, to Jan. 15, 2025:

• Submit charges incurred from Dec. 15, 2024, to Dec. 31, 2024, on one claim
• Submit charges incurred from Jan. 1, 2025, to Jan. 15, 2025, on a separate claim

Claims submitted with charges incurred during both years on the same claim will be rejected back to the provider to split the claim.