Database
Timely Filing Limits Database
171 sourced rows · Verified
Filing deadlines for Medicare, Medicare Advantage, 40 state Medicaid programs and the major commercial payers — each row quoting the payer’s or agency’s own published document, with a link to it and the date we checked.
Medicare does not vary by state
Medicare Fee-For-Service is one calendar year from the date of service, set federally by 42 CFR 424.44. It is identical in all 50 states and across every MAC. A 50-state Medicare grid invents variation that does not exist. The real state axis is Medicaid.
Your contract usually overrides the published limit
UnitedHealthcare publishes no number — it directs providers to their Participation Agreement. Kaiser publishes none either. Cigna and Humana both name the provider agreement as an explicit override. Any table asserting one confident number per commercial payer is claiming more than the payer does.
Showing all 171 rows
| Payer | Type | Deadline, as published | Source |
|---|---|---|---|
| Medicare Fee-For-Service Medicare Fee-For-Service | Initial claim | 1 calendar year after the date of service | eCFR — 42 CFR 424.44(a)(1) (Title 42, Chapter IV, Part 424, Subpart C) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Corrected / resubmitted | No timely filing period for adjustments; but a DRG-increasing inpatient PPS adjustment must be submitted within 60 days of the date of the remittance for the original claim | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70.5 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Corrected / resubmitted | Subject to the rules governing administrative finality, rather than the time limitation for filing; identified by a 'Q' in the 4th position of the Type of Bill | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70.5 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Corrected / resubmitted | Within 1 year from the date of the initial determination or redetermination | eCFR — 42 CFR 405.980(b)(1) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Corrected / resubmitted | Within 1 year for any reason; within 4 years for good cause; at any time to correct a clerical error | eCFR — 42 CFR 405.980(c) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Corrected / resubmitted | A contractor must process clerical errors (which includes minor errors and omissions) as reopenings, instead of as redeterminations | eCFR — 42 CFR 405.980(a)(3) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | Not an 'initial determination'; not subject to appeal | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70.4 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | 120 calendar days from the date a party receives the notice of the initial determination | eCFR — 42 CFR 405.942(a) (Part 405 Subpart I) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | 180 calendar days from the date the party receives the notice of the redetermination | eCFR — 42 CFR 405.962(a) (Part 405 Subpart I) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | 60 calendar days after receipt of the notice of the QIC's reconsideration | eCFR — 42 CFR 405.1002(a)(1) (Part 405 Subpart I) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | 60 calendar days after receipt of the ALJ's or attorney adjudicator's decision or dismissal | eCFR — 42 CFR 405.1102(a)(1) (Part 405 Subpart I) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | 60 calendar days after the date it receives notice of the Council's decision | eCFR — 42 CFR 405.1130 (Part 405 Subpart I) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | $200.00 for an ALJ hearing; $1,960.00 for judicial review | CMS / Federal Register — 'Medicare Program; Medicare Appeals; Adjustment to the Amount in Controversy Threshold Amounts for Calendar Year 2026', 90 FR 55869 (Dec. 4, 2025) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | $100 base for ALJ hearings and $1,000 base for judicial review, each indexed by the CPI medical care component from July 2003 and rounded to the nearest $10 | eCFR — 42 CFR 405.1006(b)-(c) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Appeal / reconsideration | Five levels: (1) Redetermination by a MAC; (2) Reconsideration by a QIC; (3) Decision by OMHA; (4) Review by the Medicare Appeals Council; (5) Judicial Review in Federal District Court | CMS — 'Original Medicare (Fee-for-service) Appeals' |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | Four exceptions: (1) administrative error by CMS/contractor/HHS agent; (2) retroactive Medicare entitlement; (3) retroactive Medicare entitlement plus State Medicaid recoupment 6+ months after service; (4) retroactive disenrollment from an MA plan or PACE organization with recoupment 6+ months after service | eCFR — 42 CFR 424.44(b) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | Through the last day of the sixth calendar month following the triggering month; no extension for the administrative-error exception if requested more than 4 years after the date of service | eCFR — 42 CFR 424.44(b)(5)(i) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | Extended to the next succeeding workday | eCFR — 42 CFR 424.44(c) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | Section 6404 of the PPACA reduced the maximum submission period for all Medicare FFS claims to one calendar year after the date of service | CMS — 'Timely Filing Requirements for Medicare Fee-For-Service Claims' (CMS listserv provider notice) |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | No later than 12 months, or 1 calendar year, after the date the services were furnished | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | Date of service / 'From' date on the claim; 'Through' date for institutional span-date claims; line-item 'From' date for professional span-date claims; Feb 29 services must be filed by Feb 28 of the following year | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70.1 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | The date the submission is received by the appropriate Medicare claims processing contractor | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70.3 |
| Medicare Fee-For-Service Medicare Fee-For-Service | Other rule | NO — it is a single uniform federal deadline set by regulation; it does not vary by state or by Medicare Administrative Contractor | CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, §70; 42 CFR 424.44(a)(1) |
| Medicare Advantage plans Medicare Advantage | Appeal / reconsideration | Service or item: 30 calendar days. Payment request: 60 calendar days. Part B drug: 7 calendar days (not extendable). Expedited: 72 hours. | eCFR — 42 CFR 422.590 |
| Medicare Advantage plans Medicare Advantage | Appeal / reconsideration | 60 calendar days of receipt of the notice of a reconsidered determination | eCFR — 42 CFR 422.602(b) (Part 422 Subpart M) |
| Medicare Advantage plans Medicare Advantage | Other rule | No CMS-set claim submission deadline for contracted providers; filing/payment terms are set by the contract between the MA organization and the provider | eCFR — 42 CFR 422.520(b) |
| Medicare Advantage plans Medicare Advantage | Other rule | 95 percent of 'clean claims' within 30 days of receipt (MA private fee-for-service enrollees and services not furnished under written agreement); all other noncontracted-provider claims paid or denied within 60 calendar days | eCFR — 42 CFR 422.520(a) |
| Medicare Advantage plans Medicare Advantage | Other rule | Standard service/item: 14 calendar days (7 calendar days beginning January 1, 2026 for items subject to the §422.122 prior authorization rules); extendable by up to 14 calendar days. Part B drug: 72 hours, not extendable. Payment requests: per the §422.520 prompt payment provisions. | GPO printed CFR / eCFR — 42 CFR 422.568(b)-(c) (Part 422 Subpart M) |
| Medicare Advantage plans Medicare Advantage | Other rule | The standards established under Part 422 supersede any State law or regulation, other than State licensing laws or State laws relating to plan solvency | eCFR — 42 CFR 422.402 |
| Medicare Advantage plans Medicare Advantage | Other rule | The standards established under this part shall supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) with respect to MA plans which are offered by MA organizations under this part | GovInfo / U.S. Code — 42 U.S.C. 1395w-26(b)(3) |
| Arizona Medicaid State Medicaid | Initial claim | 6 months after the date of service (for inpatient hospital claims, from date of discharge); retro-eligibility: 6 months from the date eligibility is posted | AHCCCS Fee-For-Service Provider Billing Manual (Master, all chapters), Chapter 4 — General Billing Rules archive-verified |
| Arizona Medicaid State Medicaid | Corrected / resubmitted | 12 months from the date of service to resubmit to clean-claim status or adjust a previously processed claim (12 months from AHCCCS eligibility-posting date in retro-eligibility cases) | AHCCCS Fee-For-Service Provider Billing Manual, Chapter 4 — General Billing Rules archive-verified |
| Arizona Medicaid State Medicaid | Third-party or Medicare primary | Initial claim still due within 6 months of date of service even if Medicare/other insurance has not paid; 12 months from date of service to resubmit with the Medicare/other-insurance remit | AHCCCS Fee-For-Service Provider Billing Manual — Medicare / Other Insurance, Timely Filing archive-verified |
| California Medi-Cal State Medicaid | Initial claim | Within six months following the month in which services were rendered ("six-month billing limit") | Medi-Cal Provider Manual, Part 1 — Claim Submission and Timeliness Overview (claim sub) archive-verified |
| California Medi-Cal State Medicaid | Corrected / resubmitted | Claims Inquiry Form (CIF): within six months from the date of the RAD. Appeal: within 90 days from the date on the RAD, Claims Inquiry Response Letter or Claims Inquiry Acknowledgement | Medi-Cal Provider Manual, Part 1 — Claim Submission and Timeliness Overview (claim sub), Delay Reason Codes archive-verified |
| California Medi-Cal State Medicaid | Other rule | 7th–9th month after month of service: paid at 75%; 10th–12th month: paid at 50%; after the 12th month: denied | Medi-Cal Provider Manual, Part 1 — Claim Submission and Timeliness Overview (claim sub) archive-verified |
| Colorado Medicaid State Medicaid | Initial claim | At least 365 days from the date of service | Colorado Department of Health Care Policy & Financing — Timely Filing Frequently Asked Questions archive-verified |
| Colorado Medicaid State Medicaid | Corrected / resubmitted | Resubmit every 60 days after the initial 365-day period, referencing the previous Internal Control Number (ICN), to keep the claim timely | Colorado Department of Health Care Policy & Financing — Timely Filing Frequently Asked Questions archive-verified |
| Colorado Medicaid State Medicaid | Third-party or Medicare primary | Commercial insurance/TPL: 365 days with no extension. Medicare primary: an additional 120 days from the Medicare payment or denial | Colorado Department of Health Care Policy & Financing — Timely Filing Frequently Asked Questions archive-verified |
| Delaware Medicaid State Medicaid | Initial claim | No later than twelve months from the date of service | Delaware Medical Assistance Program — General Policy Manual (Provider Policy Manual), §1.19.1 |
| Delaware Medicaid State Medicaid | Corrected / resubmitted | Claims filed inside 12 months but unpaid: considered if initial submission is documented and the submission date is within 24 months of the date of service. Paid claims may be adjusted up to two years from the date of service. | Delaware Medical Assistance Program — General Policy Manual, §§1.19.2 and 1.19.3 |
| Delaware Medicaid State Medicaid | Third-party or Medicare primary | Up to six months after the provider receives notice of the disposition of the claim, even if received more than twelve months after the date of service | Delaware Medical Assistance Program — General Policy Manual, §1.19.1.1 |
| Hawaii Medicaid State Medicaid | Initial claim | Within 12 months of the date of service (covers initial claims, resubmitted outstanding claims, and additional payment requests) | Hawaii Medicaid Provider Manual, Chapter 4 — Claims Payments, §4.3.5 Filing Deadline |
| Hawaii Medicaid State Medicaid | Third-party or Medicare primary | Within 6 months from the date listed on the primary payer's EOB, or 12 months from date of service, whichever is greater | Hawaii Medicaid Provider Manual, Chapter 4 — Claims Payments, §4.3.5 Filing Deadline |
| Idaho Medicaid State Medicaid | Initial claim | Within 12 months (365 days) of the start date of service; for institutional claims, from the through date of service | Idaho Medicaid Provider Handbook — General Billing Instructions, §1.12 Timely Filing Limit archive-verified |
| Idaho Medicaid State Medicaid | Third-party or Medicare primary | Within 12 months (365 days) of the start date of service or six (6) months of the date of payment / date of the Medicare EOB or Remittance Notice, whichever is greater | Idaho Medicaid Provider Handbook — General Billing Instructions, §1.12 Timely Filing Limit archive-verified |
| Illinois Medicaid State Medicaid | Initial claim | 180 days from date of service (applies to both initial and re-submitted claims) | Illinois HFS Division of Medical Programs — Timely Filing Claim Submittal for Non-Institutional Providers |
| Illinois Medicaid State Medicaid | Corrected / resubmitted | Replacement or void of a paid (or pending-to-pay) claim: within 12 months from the original paid voucher date. After a void, the new original claim is timely only if received within 90 days of the void DCN. | Illinois HFS Division of Medical Programs — Timely Filing Claim Submittal for Non-Institutional Providers |
| Illinois Medicaid State Medicaid | Third-party or Medicare primary | 180 days following final adjudication by the TPL source(s); primary TPL recoupment: 180 days from the date of the recoupment notification letter | Illinois HFS Division of Medical Programs — Timely Filing Claim Submittal for Non-Institutional Providers |
| Indiana Medicaid State Medicaid | Initial claim | 180 calendar days of the date the service was rendered; for inpatient claims, 180 days from the member's date of discharge | IHCP Provider Reference Module — Claim Submission and Processing, Section 11: Claim Filing Limits (Library Reference Number PROMOD00004, Version 8.5) |
| Indiana Medicaid State Medicaid | Corrected / resubmitted | Corrected resubmission of a denied claim is treated as an initial claim — 180-day limit from date of service. Adjustment or void/replacement of a paid claim: within 60 days of notification (date on the Remittance Advice). | IHCP Provider Reference Module — Claim Submission and Processing, 'Filing Limits for Claim Resubmissions, Adjustments and Requests for Administrative Review' |
| Indiana Medicaid State Medicaid | Appeal / reconsideration | Written request for administrative review must be filed within 60 days of notification of the claim's disposition (date on the Remittance Advice) | IHCP Provider Reference Module — Claim Submission and Processing, 'Filing Limits for Claim Resubmissions, Adjustments and Requests for Administrative Review' |
| Indiana Medicaid State Medicaid | Third-party or Medicare primary | Timely filing limit extended to 180 days from the date on the primary payer's Explanation of Benefits when third-party payer notification is delayed | IHCP Provider Reference Module — Claim Submission and Processing, 'When Timely Filing Limit Is Extended' |
| Iowa Medicaid State Medicaid | Initial claim | 365 days from the date of service; no claim will be paid past two years from the date of service | Iowa Department of Human Services — All Providers, Chapter IV. Billing Iowa Medicaid, Section B. Timely Filing Requirements |
| Iowa Medicaid State Medicaid | Corrected / resubmitted | Resubmitted claim must be received within 365 days of the Medicaid remittance advice date of denial; after a second denial, up to one year from the last adjudication, not exceeding two years from date of service | Iowa Department of Human Services — All Providers, Chapter IV. Billing Iowa Medicaid, Section B |
| Iowa Medicaid State Medicaid | Third-party or Medicare primary | Third-party related delays must be received at the IME within 365 days of the TPL process date (billed on paper with a copy of the TPL explanation of benefits) | Iowa Department of Human Services — All Providers, Chapter IV. Billing Iowa Medicaid, Section B |
| Louisiana Medicaid State Medicaid | Initial claim | Straight Medicaid claims: within 12 months of the date of service (KIDMED claims: 60 days from date of service) | Louisiana Department of Health / Louisiana Medicaid — Timely Filing Guidelines (lamedicaid.com, Gainwell Technologies fiscal intermediary) |
| Louisiana Medicaid State Medicaid | Third-party or Medicare primary | Claims with third-party payment: within 12 months of the date of service. Medicare/Medicaid dual claims must be filed with the Medicare FI within 12 months of DOS; crossovers filed hard copy must be filed within six months after the EOMB date, provided they were filed with Medicare within one year of DOS. | Louisiana Department of Health / Louisiana Medicaid — Timely Filing Guidelines |
| Louisiana Medicaid State Medicaid | Other rule | Claims with dates of service over two years old will not be considered for a timely filing override except for retroactive certification, a won Medicare/Social Security appeal granting retroactive benefits, or state fault | Louisiana Department of Health / Louisiana Medicaid — Timely Filing Guidelines |
| Maine Medicaid State Medicaid | Initial claim | One (1) year from the date services are provided, regardless of when eligibility is verified | MaineCare Benefits Manual, Chapter I Section 1 — General Administrative Policies and Procedures, §1.10-2 Time Limits for Submission of Claims archive-verified |
| Maine Medicaid State Medicaid | Third-party or Medicare primary | One (1) year from the date on the carrier's explanation of benefits (cases involving other insurance carriers or Workers' Compensation); retroactive eligibility: one year from the date MaineCare eligibility was granted | MaineCare Benefits Manual, Chapter I Section 1, §1.10-2 archive-verified |
| Maryland Medicaid State Medicaid | Initial claim | Within 12 months of the date of service (date of discharge for hospital inpatient; month of service for nursing/rehabilitation facility or hospice) | Code of Maryland Regulations (COMAR) 10.09.36.06 — Billing Time Limitations |
| Maryland Medicaid State Medicaid | Corrected / resubmitted | Received by the Program within the later of 12 months from the date of service or 60 days from the date last received by the Program or last rejected by the Program | COMAR 10.09.36.06B(5) — Billing Time Limitations |
| Maryland Medicaid State Medicaid | Third-party or Medicare primary | Within 12 months of the date of service or 120 days from the Medicare remittance date shown on the Explanation of Medicare Benefits, whichever is later — for both Medicare-approved and Medicare-denied services | COMAR 10.09.36.06B(2) — Billing Time Limitations |
| Massachusetts Medicaid State Medicaid | Initial claim | 90 days from the date of service or the date of the explanation of benefits from another insurer | 130 CMR 450.309 — Time Limitation on Submission of Claims: General Requirements (MassHealth Administrative and Billing Regulations, Transmittal Letter ALL-254) |
| Massachusetts Medicaid State Medicaid | Appeal / reconsideration | Appeal must be filed within 30 days after the date on the remittance advice that first denied the claim for exceeding the final billing deadline; claims for dates of service more than 36 months old are not eligible | 130 CMR 450.323 — Appeals of Erroneously Denied or Underpaid Claims |
| Massachusetts Medicaid State Medicaid | Third-party or Medicare primary | No later than the 90th day after the date of the notice of final disposition by the health insurer, AND no later than 18 months after the date of service | 130 CMR 450.313 — Time Limitation on Submission of Claims: Claims for Members with Health Insurance |
| Massachusetts Medicaid State Medicaid | Other rule | No payment for any claim submitted or resubmitted for services provided more than 12 months before the date of submission or resubmission | 130 CMR 450.314 — Final Deadline for Submission of Claims |
| Minnesota Medicaid State Medicaid | Initial claim | No later than 12 months from the date of service (including Medicare crossover and third-party liability claims) | MHCP Provider Manual — Billing Policy Overview, 'Timely Billing' (Minnesota Department of Human Services) |
| Minnesota Medicaid State Medicaid | Corrected / resubmitted | Replacement claims: within six months of the date of incorrect payment, or within 12 months from the date of service, whichever is greater | MHCP Provider Manual — Billing Policy Overview, 'Timely Billing' |
| Minnesota Medicaid State Medicaid | Third-party or Medicare primary | Medicare crossover claims that do not automatically cross over: within six months of the Medicare determination or adjudication date, or within 12 months of the date of service, whichever is greater | MHCP Provider Manual — Billing Policy Overview, 'Timely Billing' |
| Mississippi Medicaid State Medicaid | Initial claim | No later than three hundred sixty-five (365) calendar days from the date of service | Mississippi Administrative Code Title 23: Medicaid, Part 200 — General Provider Information, Rule 1.6 Timely Filing |
| Mississippi Medicaid State Medicaid | Appeal / reconsideration | Written request for Administrative Review within ninety (90) calendar days of the denial of a claim (or of the date of the remittance advice where the Division adjusts claims after the processing period) | Mississippi Administrative Code Title 23, Part 200, Rules 1.7 and 1.8 |
| Mississippi Medicaid State Medicaid | Third-party or Medicare primary | Medicaid claim relating to the same services processed within one hundred eighty (180) calendar days after notice of the disposition of the Medicare claim | Mississippi Administrative Code Title 23, Part 200, Rule 1.6.D Timely Filing |
| Montana Medicaid State Medicaid | Initial claim | 12 months from the later of date of service or date retroactive eligibility/disability is determined | Montana DPHHS — General Information for Providers Manual, Billing Procedures chapter (medicaidprovider.mt.gov) |
| Montana Medicaid State Medicaid | Corrected / resubmitted | Adjustments within 12 months from the date of service; rebilling within the same timely filing limits | Montana DPHHS — General Information for Providers Manual, Remittance Advices and Adjustments chapter |
| Montana Medicaid State Medicaid | Appeal / reconsideration | 30 days from the date the Department's contested determination was mailed | Montana DPHHS — General Information for Providers Manual |
| Montana Medicaid State Medicaid | Third-party or Medicare primary | 6 months from the Medicare EOB date (crossover) or 6 months from a third-party payer adjustment notice, where the 12-month limit has passed | Montana DPHHS — General Information for Providers Manual, Billing Procedures chapter |
| Nebraska Medicaid State Medicaid | Initial claim | 6 months from the date of service | Nebraska DHHS, Division of Medicaid and Long-Term Care — Nebraska Medicaid Provider Manual |
| Nebraska Medicaid State Medicaid | Third-party or Medicare primary | 12 months from date of service for other health insurance; 24 months from date of service for casualty insurance | Nebraska DHHS — Nebraska Medicaid Provider Manual |
| Nevada Medicaid State Medicaid | Initial claim | 180 days from the date of service or date of eligibility decision, whichever is later (in-state providers, no TPL) | Nevada Medicaid (DHCFP / Gainwell fiscal agent) — Billing Manual |
| Nevada Medicaid State Medicaid | Appeal / reconsideration | 30 calendar days from the date on the remittance advice listing the claim as denied | Nevada Medicaid — Billing Manual, Claim Appeals |
| Nevada Medicaid State Medicaid | Third-party or Medicare primary | 365 days from the date of service or date of eligibility decision, whichever is later | Nevada Medicaid — Billing Manual |
| New Hampshire Medicaid State Medicaid | Initial claim | 1 year following the earliest date of service on the claim | New Hampshire Medicaid (NH DHHS / NH MMIS) — General Billing Provider Manual, Volume I |
| New Hampshire Medicaid State Medicaid | Corrected / resubmitted | 15 months from the date of service (paper resubmission with Form 957X Override Request) | NH Medicaid — General Billing Provider Manual, Volume I |
| New Hampshire Medicaid State Medicaid | Appeal / reconsideration | 30 days from the date of the letter regarding continued claim denial | NH Medicaid — General Billing Provider Manual, Volume I |
| New Hampshire Medicaid State Medicaid | Third-party or Medicare primary | 12 months from the date of service | NH Medicaid — General Billing Provider Manual, Volume I |
| New Jersey Medicaid State Medicaid | Initial claim | 1 year of the service date (as stated in a NJ DHS publication describing the NJ FamilyCare/Medicaid claim system) | New Jersey Department of Human Services, Division of Mental Health and Addiction Services — Mental Health Fee-for-Service Provider Manual |
| New Mexico Medicaid State Medicaid | Initial claim | 90 calendar days from the date of service (inpatient: 90 calendar days from discharge/transfer) | New Mexico Administrative Code 8.302.2 NMAC — Billing for Medicaid Services (NM State Records Center & Archives) |
| New Mexico Medicaid State Medicaid | Corrected / resubmitted | 90 calendar days from the date of the return, denial, or incorrect payment (one-time grace period only) | New Mexico Administrative Code 8.302.2.11 NMAC |
| New Mexico Medicaid State Medicaid | Third-party or Medicare primary | 90 calendar days from the date the other payer paid or denied, not to exceed 210 calendar days from the date of service | New Mexico Administrative Code 8.302.2.11 NMAC |
| New York Medicaid State Medicaid | Initial claim | 90 days from the date of service | eMedNY / NYS Department of Health — Information for All Providers: General Billing |
| New York Medicaid State Medicaid | Corrected / resubmitted | 60 days from the date of notification to the provider (rejected/denied claims and adjustments to paid claims) | eMedNY / NYS DOH — Information for All Providers: General Billing |
| New York Medicaid State Medicaid | Third-party or Medicare primary | 30 days from the date submission came within the control of the provider (delay reason code 7) | eMedNY / NYS DOH — Information for All Providers: General Billing, HIPAA Delay Reasons |
| North Carolina Medicaid State Medicaid | Initial claim | 365 days from the date of service (inpatient hospital and nursing facility: 365 days from the last date of service) | NC Medicaid / NCTracks — Job Aid GEN201, Provider Adjustments, Time Limit Overrides, and Medicare Overrides |
| North Carolina Medicaid State Medicaid | Corrected / resubmitted | 18 months from the last remittance advice date, where the original claim was filed within 365 days | NC Medicaid / NCTracks — Job Aid GEN201 |
| North Carolina Medicaid State Medicaid | Third-party or Medicare primary | 180 days from the primary insurer's EOB date, regardless of date of service | NC Medicaid / NCTracks — Job Aid GEN201 |
| North Dakota Medicaid State Medicaid | Initial claim | 180 days from the date of service | North Dakota HHS — ND Medicaid Billing and Policy Manual, Timely Filing |
| North Dakota Medicaid State Medicaid | Corrected / resubmitted | 365 days from the date of service, provided the original claim met timely filing | North Dakota HHS — ND Medicaid Billing and Policy Manual, Timely Filing |
| North Dakota Medicaid State Medicaid | Appeal / reconsideration | 30 days from the date of the department's denial of payment | North Dakota HHS — ND Medicaid Billing and Policy Manual, Timely Filing (Appeals) |
| North Dakota Medicaid State Medicaid | Third-party or Medicare primary | 365 days from the date of service for original secondary/tertiary claims | North Dakota HHS — ND Medicaid Billing and Policy Manual, Timely Filing |
| North Dakota Medicaid State Medicaid | Third-party or Medicare primary | 180 days from the date on the Medicare Explanation of Benefits | North Dakota HHS — ND Medicaid Billing and Policy Manual, Timely Filing |
| Ohio Medicaid State Medicaid | Initial claim | 365 days from the actual date the service was provided (inpatient hospital: 365 days from date of discharge) | Ohio Administrative Code Rule 5160-1-19, Claim submission (codes.ohio.gov / Ohio Laws) |
| Ohio Medicaid State Medicaid | Corrected / resubmitted | 365 days from the date of service or inpatient hospital discharge (denied claims resubmitted; underpaid claims adjusted) | Ohio Administrative Code Rule 5160-1-19 |
| Ohio Medicaid State Medicaid | Third-party or Medicare primary | Automatic Medicare crossover claims are exempt from timely filing; third-party payment reversals allow 180 days from recovery of funds | Ohio Administrative Code Rule 5160-1-19 |
| Oklahoma Medicaid State Medicaid | Initial claim | 6 months from the date of service (for dates of service on or after July 1, 2015) | Oklahoma Health Care Authority — OAC 317:30-3-11, Timely filing limitation |
| Oklahoma Medicaid State Medicaid | Third-party or Medicare primary | 90 days after notice of the disposition of the Medicare claim | Oklahoma Health Care Authority — OAC 317:30-3-11 |
| Oregon Medicaid State Medicaid | Initial claim | 365 days from the date of service, with an additional 180 days to resolve a claim that was submitted within 365 days | Oregon Health Authority, Medicaid Division — General Rules Provider Guide |
| Pennsylvania Medicaid State Medicaid | Initial claim | 180 calendar days after the date the services were rendered (nursing facility / ICF/MR: 180 days from the last day of a billing period) | Pennsylvania Code § 1101.68 (Invoicing for services) — Pennsylvania Code and Bulletin |
| Pennsylvania Medicaid State Medicaid | Corrected / resubmitted | 365 days from the date of service | Pennsylvania Code § 1101.68 |
| Pennsylvania Medicaid State Medicaid | Appeal / reconsideration | 30 days from the date of the notice of the action | Pennsylvania Code § 1101.84 (Provider right of appeal) |
| Pennsylvania Medicaid State Medicaid | Third-party or Medicare primary | Third-party payment requested within 60 days of the date of service AND invoice exception request received within 60 days of receipt of the third party's statement | Pennsylvania Code § 1101.68 |
| Rhode Island Medicaid State Medicaid | Initial claim | 365 days from the date of service (claims with no other health insurance) | Rhode Island EOHHS — RI Medicaid Provider Reference Manual, General Guidelines |
| Rhode Island Medicaid State Medicaid | Corrected / resubmitted | 90 days from the remittance advice date on which the original claim payment posted (for claims over one year old) | Rhode Island EOHHS — RI Medicaid Provider Reference Manual, General Guidelines |
| Rhode Island Medicaid State Medicaid | Third-party or Medicare primary | 90 days from the third-party payer's valid EOB date, for claims with a date of service over one year old | Rhode Island EOHHS — RI Medicaid Provider Reference Manual, General Guidelines |
| South Carolina Medicaid State Medicaid | Initial claim | 1 year from the date of service (or date of discharge for hospital claims) | South Carolina DHHS — Provider Administrative and Billing Manual |
| South Carolina Medicaid State Medicaid | Appeal / reconsideration | 30 days of the date of receipt of the notice of adverse action | South Carolina DHHS — Provider Administrative and Billing Manual, Provider Appeals |
| South Carolina Medicaid State Medicaid | Third-party or Medicare primary | TPL does not extend the one-year limit; Medicare cost-sharing claims: 2 years from date of service/discharge or 6 months following the date of Medicare payment, whichever is later | South Carolina DHHS — Provider Administrative and Billing Manual |
| South Dakota Medicaid State Medicaid | Initial claim | 6 months following the month the services were provided | South Dakota DSS — South Dakota Medicaid Billing and Policy Manual, General Claim Guidance |
| South Dakota Medicaid State Medicaid | Corrected / resubmitted | 3 months after the previously paid claim (adjustment or void) or 3 months after a previously denied claim | South Dakota DSS — Billing and Policy Manual, General Claim Guidance |
| South Dakota Medicaid State Medicaid | Appeal / reconsideration | Reconsideration: within 6 months of the date of service or within 3 months from the denial remittance. Fair hearing: 30 days of the decision date | South Dakota DSS — Billing and Policy Manual, Reconsideration Reviews, Coverage Requests, and Fair Hearings |
| South Dakota Medicaid State Medicaid | Third-party or Medicare primary | 6 months after the provider receives payment or a notice of denial from Medicare or private health insurance (claim must include the primary insurer's EOB) | South Dakota DSS — Billing and Policy Manual, General Claim Guidance |
| Tennessee TennCare State Medicaid | Initial claim | 1 year | TennCare Policy Manual — Policy PAY 13-001 (Rev. 2), Timely Filing |
| Tennessee TennCare State Medicaid | Third-party or Medicare primary | 6 months from the date the provider was notified by Medicare of payment or denial, where the claim is outside the one-year limit and did not auto-cross | TennCare Policy Manual — PAY 13-001 (Rev. 2), Timely Filing |
| Tennessee TennCare State Medicaid | Third-party or Medicare primary | The clock starts on the date the third party documents resolution of the claim | TennCare Policy Manual — PAY 13-001 (Rev. 2), Section 2. Third Party Liability |
| Texas Medicaid State Medicaid | Initial claim | 95 days from each date of service (out-of-state providers: 365 days from the DOS) | Texas Medicaid Provider Procedures Manual, Vol. 1, Section 6: Claims Filing (TMHP/HHSC) |
| Texas Medicaid State Medicaid | Corrected / resubmitted | 120 days from the date of disposition on the R&S Report | Texas Medicaid Provider Procedures Manual, Vol. 1, Section 7: Appeals |
| Texas Medicaid State Medicaid | Third-party or Medicare primary | 95 days from the date of Medicare disposition; 95 days from the date of disposition by another insurance resource; must allow 110 days to elapse if a third party does not respond | Texas Medicaid Provider Procedures Manual, Vol. 1, Section 6: Claims Filing |
| Utah Medicaid State Medicaid | Initial claim | 365 days from the date of service | Utah Department of Health and Human Services — Utah Medicaid Provider Manual, Section I: General Information |
| Utah Medicaid State Medicaid | Corrected / resubmitted | Within the same 365-day period from the date of service | Utah DHHS — Utah Medicaid Provider Manual, Section I: General Information |
| Utah Medicaid State Medicaid | Appeal / reconsideration | 30 days of the claim denial (documentation plus Timely Filing Document Submission Form) | Utah DHHS — Utah Medicaid Provider Manual, Section I: General Information |
| Utah Medicaid State Medicaid | Third-party or Medicare primary | 365 days from date of service or six months after Medicare disposition | Utah DHHS — Utah Medicaid Provider Manual, Section I: General Information |
| Vermont Medicaid State Medicaid | Initial claim | 180 days from the begin date of service (inpatient: 180 days from the discharge/through date) | Department of Vermont Health Access — Vermont Medicaid General Billing and Forms Manual |
| Vermont Medicaid State Medicaid | Corrected / resubmitted | Corrected claims: 180 days from the initial Medicaid denial. Previously adjusted or recouped claims: 180 days from the adjustment/recoup date. Timely filing reconsideration requests: 90 days from the initial Medicaid timely filing denial | DVHA — Vermont Medicaid General Billing and Forms Manual |
| Vermont Medicaid State Medicaid | Third-party or Medicare primary | Medicare primary: 180 days from Medicare's processing date. Other insurance (excluding Medicare) primary: 365 days from the date of service | DVHA — Vermont Medicaid General Billing and Forms Manual |
| Virginia Medicaid State Medicaid | Initial claim | 12 months from the date of service | Virginia DMAS — Practitioner Provider Manual, Chapter V: Billing Instructions |
| Virginia Medicaid State Medicaid | Corrected / resubmitted | On or before 13 months from the date of the initial claim denial (where the initial claim was filed timely) | Virginia DMAS — Practitioner Provider Manual, Chapter V: Billing Instructions |
| Virginia Medicaid State Medicaid | Third-party or Medicare primary | 12 months from the date of service — waiting for the primary payer does not extend the deadline | Virginia DMAS — Practitioner Provider Manual, Chapter V: Billing Instructions |
| Washington Medicaid State Medicaid | Initial claim | 365 days from the date of service; resubmit/modify/adjust a timely initial claim for 24 months from the date of service | Washington State Health Care Authority — ProviderOne Billing and Resource Guide |
| Washington Medicaid State Medicaid | Third-party or Medicare primary | Medicare crossover: 6 months from the Medicare processing date initially, and 2 years from the "from" date of service for resubmissions/voids/adjustments. Commercial payer takeback: 1 year from the date of the takeback | Washington State HCA — ProviderOne Billing and Resource Guide |
| West Virginia Medicaid State Medicaid | Initial claim | 12 months from date of service | West Virginia Bureau for Medical Services (BMS) — Provider Manual Chapter 100, General Administration/General Information |
| West Virginia Medicaid State Medicaid | Corrected / resubmitted | 24 months from the date of service for denied claims to be billed with corrections or paid claims to be replaced | West Virginia BMS — Provider Manual Chapter 100, §100.15 Timely Claims Filing |
| West Virginia Medicaid State Medicaid | Third-party or Medicare primary | Non-Medicare TPL: 12 months from date of service. Medicare + TPL: 12 months from the date of the Medicare payment | West Virginia BMS — Provider Manual Chapter 100, §100.16 Third Party Liability (TPL) |
| Wisconsin Medicaid State Medicaid | Initial claim | 365 days from the date of service | Wisconsin DHS / ForwardHealth — ForwardHealth Update No. 2018-30, "Clarification of the Timely Filing Claims Submission Process" |
| Wisconsin Medicaid State Medicaid | Corrected / resubmitted | Adjustments allowed on the Portal for claims paid within 365 days of the DOS; adjustments beyond 365 days must go through the paper timely-filing process | Wisconsin DHS / ForwardHealth — ForwardHealth Online Handbook (archived Rural Health Clinic service-area compilation, 05/03/2021) |
| Wyoming Medicaid State Medicaid | Initial claim | 12 months (365 days) of the date of service | Wyoming Department of Health, Division of Healthcare Financing — Wyoming Medicaid CMS-1500 Provider Manual, §6.19 Timely Filing |
| Wyoming Medicaid State Medicaid | Corrected / resubmitted | No specific time limit for correcting errors; corrected claim must be submitted in a timely manner from when the error was discovered | Wyoming DOH — Wyoming Medicaid CMS-1500 Provider Manual, §6.19.1 |
| Wyoming Medicaid State Medicaid | Third-party or Medicare primary | 12 months (365 days) of the date of service or within six (6) months (180 days) from the payment date on the Medicare EOMB, whichever is later | Wyoming DOH — Wyoming Medicaid CMS-1500 Provider Manual, §6.19.1 |
| UnitedHealthcare Commercial payer | Initial claim | Not a fixed number — "Refer to your internal contracting contact or Participation Agreement for timely filing information." | 2026 UnitedHealthcare Care Provider Administrative Guide for Commercial, Individual Exchange and Medicare Advantage |
| UnitedHealthcare Commercial payer | Initial claim | At least 90 days for participating providers; up to 180 days for nonparticipating providers (commercial); 365 days from through-date of service for noncontracted providers (Medicare Advantage) | 2026 UnitedHealthcare Care Provider Administrative Guide — Capitation and/or delegation supplement, "Time limits for filing claims" |
| UnitedHealthcare Community Plan of Wisconsin (Medicaid) Commercial payer | Initial claim | Non-network initial claims: 365 days from date of service. Corrected claim: 180 calendar days from the original remittance date. Claim reconsideration: 60 calendar days from the original remittance date. | UnitedHealthcare — Time frames for claim submissions and appeals, Quick reference guide for Wisconsin |
| Cigna Commercial payer | Initial claim | Participating provider claims: three (3) months [90 days] after the date of service. Out-of-network claims: six (6) months [180 days] after the date of service. | Cigna for Health Care Professionals (CHCP) — Claim Policies and Procedures: When to File / Timely Filing Policy |
| Humana Commercial payer | Initial claim | Medicare lines of business: one year from date of service. Medicaid lines of business: refer to the state-specific Medicaid provider manual. Explicitly subject to "the agreement or applicable state or federal law". | Humana 2025 Provider Manual for physicians, hospitals and healthcare providers (doc code 589003ALL1024 GHHMH6TEN) |
| Centene / Ambetter Commercial payer | Initial claim | Participating: 180 calendar days. Non-participating: 90 calendar days. Both measured from date of service (from date of discharge for observation and inpatient stays), or from the EOP date. | Ambetter from Magnolia Health — Provider and Billing Manual 2026 |
| Blue Cross and Blue Shield of Texas (HCSC) Commercial payer | Initial claim | 365 days from the date of service | BCBSTX PPO Provider Manual — Section F(a) Filing Claims – General Information |
| Premera Blue Cross Commercial payer | Initial claim | Ideally within 60 calendar days of the covered services, but no later than 365 calendar days from the date of submission; for most plans claims are denied if received more than 12 months after the date of service, with no member responsibility | Premera Blue Cross HMO Provider Reference Manual |
| Kaiser Permanente Commercial payer | Initial claim | No numeric limit published in the manual — "in accordance with your Agreement, this Provider Manual, and applicable law" | Kaiser Permanente Provider Manual — 8.0 Claims Billing and Payment Policies and Procedures (Mid-Atlantic States) |
| Anthem (Empire BlueCross BlueShield, New York) Commercial payer | Initial claim | 120 days from the date of service, for all claims submitted on or after October 1, 2019 | Anthem Provider News (New York) — "Changes to timely filing requirements for Commercial plans for all claims submitted to plan on or after October 1, 2019" |
| Anthem HealthKeepers Plus (Virginia Medicaid) Commercial payer | Initial claim | Initial claims: 365 days from the date of service. Corrected claims: within 12 months of the original EOP date. Claim payment reconsideration: within 12 months from issuance of the EOP. Claim payment appeal: within 15 months of service or 180 days from the reconsideration decision. | Anthem Provider News (Virginia) — "Ensure timely filing and appeal submissions for claims" |
| UnitedHealthcare Commercial payer | Corrected / resubmitted | Same number of days as the initial claim filing limit in the Participation Agreement (worked example in the guide uses 90 days from last date of service) | 2026 UnitedHealthcare Care Provider Administrative Guide — Timely filing of corrected claims |
| Centene / Ambetter Commercial payer | Corrected / resubmitted | 180 days from the date of the original explanation of payment or denial — for corrected claims, reconsiderations AND claim disputes alike | Ambetter from Magnolia Health — Provider and Billing Manual 2026, "Corrected Claims, Requests for Reconsideration or Claim Disputes" |
| Blue Cross and Blue Shield of Texas (HCSC) Commercial payer | Corrected / resubmitted | Same as the initial claims filing deadline (365 days), filed with the appropriate bill type | BCBSTX PPO Provider Manual — Section F(a) Filing Claims – General Information |
| Kaiser Permanente Commercial payer | Corrected / resubmitted | 90 calendar days (Colorado); 365 calendar days (Georgia, Hawaii, Mid-Atlantic States, Northwest); same limits as the original claim (California) — from the date of the original Remittance Advice | Kaiser Permanente Provider Manual — 8.9 Corrected Claims Processing Guidelines |
| UnitedHealthcare Commercial payer | Appeal / reconsideration | 12 months from the date of the original claim EOB or PRA (or as required by law or your Agreement); the 2-step reconsideration-then-appeal process shares one 12-month total, not 12 months per step | 2026 UnitedHealthcare Care Provider Administrative Guide — Claim reconsideration and appeals process |
| Cigna Commercial payer | Appeal / reconsideration | 180 calendar days from the date of the initial payment or denial decision from Cigna (or 180 calendar days from the date of the last payment adjustment, where the appeal relates to an adjusted payment) | Cigna for Health Care Professionals (CHCP) — Appeal Policy and Procedures for Health Care Professionals |
| Cigna Commercial payer | Appeal / reconsideration | Within one year from the date of the Single Level denial letter | Cigna for Health Care Professionals (CHCP) — Appeal Policy and Procedures for Health Care Professionals |
| Blue Cross and Blue Shield of Texas (HCSC) Commercial payer | Appeal / reconsideration | Claim dispute: within 180 days following the check date/date of the Plan's Explanation of Payment (EOP), or the date of the BCBSTX Provider Claims Summary (PCS), for the claim in dispute. Audited payment and overpayment disputes: within 45 days of the written refund request. Two levels of claim review are available. | BCBSTX HMO Provider Manual — Section F(h) Filing Claims – Claim Review Process |
| Premera Blue Cross Commercial payer | Appeal / reconsideration | Level 1: within 365 days following the action that prompted the dispute. Level 2: in writing within 30 calendar days of the level 1 appeal decision, billing issues only. Mediation: request in writing within 30 days after the level 2 decision on a billing dispute. | Premera Blue Cross HMO Provider Reference Manual — Level 1 appeal / Level 2 appeal / Mediation |
| UnitedHealthcare Commercial payer | Other rule | "If there is inconsistency between the terms of your Agreement and this guide, your Agreement controls." | 2026 UnitedHealthcare Care Provider Administrative Guide — Welcome / How to use this guide |
| Cigna Commercial payer | Other rule | Exceptions to the timely filing limits include: "Applicable law requires a longer filing period; Provider agreement specifically allows for additional time" | Cigna for Health Care Professionals (CHCP) — When to File: Exceptions To Timely Filing Limits |
| Blue Cross Blue Shield Commercial payer | Other rule | The BCBS system is composed of independent, community-based and locally operated companies; each is an independent licensee of the Blue Cross Blue Shield Association | Blue Cross Blue Shield Association — About Us (bcbs.com); corroborated by the licensee attribution line on Anthem Provider News |
No rows match those filters. Try clearing the jurisdiction or deadline type.
Coverage — including what is missing
We publish Medicaid deadlines for 40 of 51 jurisdictions. The remaining 11 are listed below rather than left as a silent gap — we could not retrieve and verify a primary source for them, and we would rather show a blank than a number a practice might rely on. A wrong filing deadline costs real money.
Not yet verified: Alabama · Alaska · Arkansas · Connecticut · District of Columbia · Florida · Georgia · Kansas · Kentucky · Michigan · Missouri
Not legal advice. These are deadlines as published by each payer or agency on the date shown. Your provider contract routinely supersedes a published limit, and payers revise manuals continuously. Confirm against your own agreement and the payer’s current manual before relying on any deadline here. Working a timely-filing denial already received? See the CO-29 denial guide.
Cite this data
Free to reuse with attribution — including the charts and the underlying dataset. Figures were verified against their primary sources on .
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Source: MedPrecision Timely Filing Limits Database 2026, MedPrecision Billing. https://www.medprecisionbilling.com/timely-filing/ Download the dataset
download CSV — every row with its own source URLCommon Questions
Common questions about timely filing deadlines.
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Get a Free Billing Audit arrow_forwardWhat is the timely filing limit for Medicare?
One calendar year from the date of service. This is set federally by 42 CFR 424.44, following Section 6404 of the Affordable Care Act, and it does not vary by state or by Medicare Administrative Contractor. CMS lists only four narrow exceptions — administrative error by CMS or its contractor, retroactive Medicare entitlement, retroactive entitlement combined with State Medicaid recoupment, and retroactive disenrolment from a Medicare Advantage or PACE organization. Where an exception applies, the extension runs through the last day of the sixth calendar month following the triggering month.
Do timely filing limits vary by state?
For Medicaid, yes — substantially. Verified initial-filing deadlines in this database range from 90 days (New York, New Mexico) and 95 days (Texas) to 12 months (Delaware, Hawaii, Virginia, West Virginia and others). For Medicare Fee-For-Service, no — it is a uniform federal deadline. For commercial payers, the variation is driven by the plan and by your individual contract rather than by geography, with the notable exception of the Blue Cross Blue Shield system, which is a federation of independent local licensees whose deadlines genuinely differ.
Why does UnitedHealthcare not publish a timely filing limit?
Because for UnitedHealthcare the deadline is contractual rather than published. Its administrative guide directs providers to “Refer to your internal contracting contact or Participation Agreement for timely filing information.” The guide does state floors — at least 90 days for participating providers and up to 180 days for non-participating providers on commercial plans, and 365 days from the through-date of service for non-contracted Medicare Advantage claims — but the governing number is in your agreement. Kaiser Permanente likewise publishes no numeric limit in its provider manual.
Does my contract override the payer’s published filing limit?
Routinely, yes, and this is the single most important caveat on any timely filing table. UnitedHealthcare states that “If there is inconsistency between the terms of your Agreement and this guide, your Agreement controls.” Cigna lists a longer provider agreement as an explicit exception to its published limits. Humana states its deadlines are subject to the agreement or applicable state or federal law. Always confirm against your own contract before relying on a published number — including the ones in this database.
Can a timely filing denial be appealed?
It depends on the payer, and Medicare is stricter than most. Under the CMS Medicare Claims Processing Manual, a timely filing denial is not an initial determination and is therefore not subject to appeal — the route is to establish that an exception applies, not to appeal the denial. Commercial payers generally will reconsider where you can produce proof of original timely submission; a clearinghouse acceptance report with its date stamp is the single most useful artefact. See our guide to the CO-29 denial code for the working process.
How current is this data?
Every row was fetched from the payer’s or agency’s own published document and verified on July 28, 2026, then independently re-fetched by a second pass instructed to refute it. 13 rows are flagged “archive” — the live host blocked retrieval from our environment, so the quote was confirmed against a dated Internet Archive snapshot instead, and an archived rule may since have changed. Payers revise provider manuals continuously; treat this as a starting point for verification, not a substitute for it.
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