Free tool · no signup
Timely filing limits, by payer
The deadline each payer publishes for receiving a claim, quoted from the payer’s own document — and where a payer publishes none, that fact instead of a guess. Pick a payer, enter the date of service, and read the date the claim must be in by.
1 calendar year. Runs from the date of service; for professional claims with span dates, the line-item "From" date.
Enter the date of service.
The limits, with the source beside each
| Payer | Limit | Counted from | Corrected claims | Secondary (COB) claims |
|---|---|---|---|---|
| Medicare (fee-for-service, Parts A and B) | 1 calendar year | the date of service; for professional claims with span dates, the line-item "From" date | The same limit — a corrected claim is a claim. A denial for untimely filing is not an initial determination and cannot be appealed. | No separate rule; the clock runs from the date of service regardless of a primary payer. |
| TRICARE | 1 year | the date of service, or the inpatient discharge date | Not stated on the source page. | Not stated on the source page. |
| Cigna Healthcare (medical) | 3 months [90 days] — participating; 6 months [180 days] — out of network | the date of service; for consecutive days such as a hospital confinement, the last date of service | A resubmission that Cigna did not request, and that is not an appeal, is subject to the filing limit. | Determined from the processing date on the primary carrier's EOB or EOP. |
| UnitedHealthcare (commercial and Medicare Advantage) | Set by your Participation Agreement | the date of service, discharge, or final outpatient visit | Within the same window as the original — "all claim information, including corrected claims". | Not stated on the source page. |
| Aetna (commercial) | Set by your provider agreement | your agreement | Not stated in the public manual. | Not stated in the public manual. |
| Humana (commercial and Medicare Advantage) | Set by your agreement and applicable law | your agreement | Not stated in the public manual. | Not stated in the public manual. |
Medicare (fee-for-service, Parts A and B): notes and sources
- A claim with a date of service on 29 February must be filed by 28 February of the following year.
- Exceptions at 42 CFR 424.44(b): administrative error by Medicare or its contractor; retroactive Medicare entitlement; retroactive entitlement involving a State Medicaid agency; retroactive disenrollment from a Medicare Advantage plan or PACE organization.
- CMS, Timely Filing Requirements for Medicare Fee-For-Service Claims (listserv notice, 1 April 2010)
“Section 6404 of the PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.” - CMS, Medicare Claims Processing Manual, Pub. 100-04, Transmittal 2140 (21 January 2011), Chapter 1 §70
“For professional claims (Form CMS-1500 and 837-P) submitted by physicians and other suppliers that include span dates of service, the line item "From" date is used for determining the date of service for claims filing timeliness.” - CMS MLN, Medicare Billing: CMS-1450 and 837I — Timely Filing
“When Medicare denies a claim filed after the timely filing period, the denial isn't an initial determination and isn't subject to appeal.”
TRICARE: notes and sources
- Overseas: 3 years from the date of service or inpatient discharge.
- Dental and pharmacy claims: 1 year from the date of service.
- TRICARE, "How long do I have to file a claim?" (FAQ)
“If you live in the U.S. or U.S. Territories, you have 1 year from the date of service or inpatient discharge to file your medical claim.”
Cigna Healthcare (medical): notes and sources
- The contract prohibits balance billing the patient for a claim denied as untimely.
- Behavioral health has its own schedule under the Cigna Behavioral Health agreement.
- Cigna for Health Care Professionals, "When to File" (effective 1 April 2015)
“Participating provider claims submitted three (3) months [90 days] after the date of service, out-of-network claims submitted six (6) months [180 days] after the date of service.” - Cigna, "When to File" — coordination of benefits
“In Coordination of Benefits situations, timely filing is determined from the processing date indicated on the primary carrier's Explanation of Benefits (EOB) or Explanation of Payment (EOP).”
UnitedHealthcare (commercial and Medicare Advantage): notes and sources
- UnitedHealthcare's worked example uses a 90-day agreement, but the page sends you to the agreement for your own figure. Enter it in the calculator.
- UHCprovider.com, "Reduce claim returns and rework"
“Submit all claim information, including corrected claims, within the required number of days after the date of service, discharge or final outpatient visit. Refer to your internal contracting contact or Participation Agreement for timely filing information.”
Aetna (commercial): notes and sources
- Aetna's public office manual (June 2022 edition, read 10 September 2026) contains no general claim-filing deadline; the figure lives in the provider agreement and the state supplements. Other sites print a number for Aetna — it is a contract term, not a published policy.
- Aetna, Provider Manual (office manual for health care professionals), June 2022 edition
Read in full on 2026-09-10: the manual states no claim-filing deadline. The figure is in the provider agreement and the state supplements.
Humana (commercial and Medicare Advantage): notes and sources
- Humana's 2025 provider manual defers to "timely filing laws, rules, regulations and policies". Humana Healthy Horizons (Kentucky Medicaid) is published: 365 calendar days from the date of service or discharge for original and corrected claims, effective 1 July 2020.
- Humana, 2025 Provider Manual for physicians, hospitals and healthcare providers
“with timely filing laws, rules, regulations and policies.” - Humana, Network Notification — Kentucky Medicaid, Timely Filing Change effective 1 July 2020 (LC8798KY1120-A)
“Effective for dates of service on or after July 1, 2020, provider claims must be submitted within 365 calendar days from the date of service or discharge. Providers also have 365 calendar days from the date of service or discharge to submit a corrected claim.”
State Medicaid programs, from the regulation
Fee-for-service limits, each quoted from the state’s own regulation or manual and linked beside it. The federal floor is 12 months; several states are far shorter. Managed-care plans set their own limits in their provider agreements, usually shorter still, and those are not on this table. Read 2026-09-11.
| State | Limit | Counted from | Resubmission |
|---|---|---|---|
| Federal floor (every state) | 12 months from the date of service — the federal minimum | the date of service | Federal rule sets no separate resubmission window; each state does. |
| Alabama | 1 year from the date of service (clean claim) | the date of service | Within 120 days of a third-party disposition notice, or 1 year of a retroactive award notice, where those apply. |
| Arizona (AHCCCS) | 6 months from the date of service to submit; 12 months to be a clean claim | the date of service (or the date eligibility is posted, if later, for the clean-claim limit) | The claim must reach clean-claim status within twelve months of the date of service. |
| California (Medi-Cal) | By the end of the sixth month following the month of service | the month of service, not the day — a 3 April service is due by 31 October | Adjustment or reconsideration within six months of the payment or denial date; an RTD must come back within 60 days. |
| Illinois (HFS) | 180 days from the date of service (non-institutional claims) | the date of service | Timely filing applies to re-submitted claims as well as initial ones. |
| Indiana (IHCP) | 180 days from the date of service (services on or after 1 January 2019) | the date of the provision of the service | Adjustment or reconsideration of a denied claim within 60 days of the paid/denied notification. |
| Iowa | 365 days from the date of service | the date of service | Resubmit or adjust within 365 days of the last adjudication (the remittance date of denial), never beyond two years from the date of service. |
| Kentucky | 12 months from the date the service was rendered | the date the service was rendered | Not stated in the section quoted. |
| Maryland | 12 months from the date of service | the date of service; the date of discharge for inpatient; the month of service for nursing, rehabilitation and hospice | Medicare-related claims: 12 months from the date of service or 120 days from the Medicare remittance date, whichever is later. |
| Massachusetts (MassHealth) | 90 days from the date of service, or from another insurer's explanation of benefits | the date of service, or the date of the other insurer's EOB; the latest date for a continuous service | Waivers only for retroactive membership, a member who did not disclose eligibility, or an exception MassHealth authorises expressly. |
| Mississippi | 365 calendar days from the date of service | the date of service | Not stated in Rule 1.6; a claim recouped by a CCO after the 365 days may be refiled within 90 days of the recoupment. |
| Missouri (MO HealthNet) | 12 months from the date of service | the date of service | A claim received in the first 12 months and denied may be resubmitted within 24 months of the date of service; adjustments to a paid claim within 24 months. |
| New Jersey | 1 year from the date of service (non-institutional); 1 year from discharge (inpatient) | the date of service; the date of discharge for inpatient hospital claims | A denied claim: within one year of the date of service or 30 days of adjudication, whichever is later. |
| New Mexico | 90 calendar days from the date of service | the date of service; the date of discharge for inpatient facility claims | A returned, denied or incorrectly paid claim: resubmit within 90 calendar days of the return, denial or payment. |
| New York (eMedNY) | 90 days from the date of service; finally payable within 2 years | the date the care, services or supplies were furnished | A returned claim not correctly resubmitted within 60 days, or on the second resubmission, is not enforceable. |
| North Carolina (NCTracks) | 365 days from the first date of service (except inpatient and nursing facility claims) | the first date of service | Not stated on the page quoted. |
| Ohio | 365 days from the date of service; from discharge for inpatient | the actual date the service was provided; the date of discharge for inpatient hospital claims | Denied claims resubmitted, and provider-reported underpayments adjusted, within 365 days of the date of service or discharge. |
| Oklahoma (SoonerCare) | 6 months from the date of service | the date of service | A denied claim can be considered proof of timely filing. |
| Pennsylvania | 180 days from the date of service (original invoice); 365 days to resubmit | the date the services were rendered | A rejected original claim or an adjustment must be received within 365 days of the date of service. |
| Tennessee (TennCare) | 1 year from the date of service | the date of service | A resubmission or follow-up of a denied claim within 6 months of the date the original was filed. |
| Texas | 95 days from each date of service (or from the TPI issue date, if later) | each date of service on the claim; the date of discharge for final inpatient claims | All claims must be finalized within 24 months of the date of service. |
| Washington (Apple Health) | 365 calendar days from the date of service, with a TCN assigned | the date of service (or a fair-hearing decision, court order or retroactive certification) | Resubmit, modify or adjust an initial claim within 24 months of the date of service (15 months for prescription drugs). |
Federal floor (every state): notes and source
- Every state must require claims within 12 months of the date of service. A state may not set a longer initial limit than this; it may set a shorter one, and several do.
- 42 CFR § 447.45(d)(1) — Timely claims payment
“The Medicaid agency must require providers to submit all claims no later than 12 months from the date of service.”
Alabama: notes and source
- A "timely claim" is a clean claim; a claim received in time but not clean does not stop the clock.
- Ala. Admin. Code r. 560-X-1-.17 — Providers' Claims
“A timely claim is a clean claim which is received by the fiscal agent within one year of the date of service”
Arizona (AHCCCS): notes and source
- One of the shortest initial limits in the country, and it is statute, not a manual.
- A.R.S. § 36-2904 — AHCCCS; claims
“The administration shall not pay claims for system covered services that are initially submitted more than six months after the date of the service for which payment is claimed or that are submitted as clean claims more than twelve months after the date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later”
California (Medi-Cal): notes and source
- Counted by month, so the calculator cannot express it in days; the deadline is the last day of the sixth following month.
- Cal. Code Regs. tit. 22, § 51008 — Bills for Service
“bills for service provided pursuant to the Medi-Cal Program shall be received by the fiscal intermediary not later than the sixth month following the month of service”
Illinois (HFS): notes and source
- Medicare crossovers (Medicare-payable claims) carry a 2-year limit from the date of service, per the same page.
- Illinois HFS — Timely Filing Claim Submittal for Non-Institutional Providers
“Non-Institutional claims are subject to a timely filing deadline of 180 days from date of service. Timely filing applies to both initial and re-submitted claims.”
Indiana (IHCP): notes and source
- Waivers exist for office error, continuous attempts to bill a third party first, and crossover failures — each must be documented.
- 405 IAC 1-1-3 — Filing of claims; filing date; waiver of limit
“For dates of service on or after January 1, 2019, provider claims for payment for services rendered to members must be originally filed with the office within one hundred eighty (180) days of the date of the provision of the service.”
Iowa: notes and source
- Two exceptions: retroactive eligibility, and third-party delays — the latter billed on paper with the TPL explanation of benefits within 365 days of the TPL process date.
- Iowa HHS — All Providers, Chapter IV. Billing Iowa Medicaid (provider manual)
“Providers have 365 days from the date of service to submit a claim.”
Kentucky: notes and source
- 907 KAR 1:673 — Medicaid claims (timely filing)
“Claims shall be submitted for payment within twelve (12) months of the date the service was rendered to an eligible Medicaid recipient for covered services or supplies.”
Maryland: notes and source
- A single claim covering several dates must arrive within 12 months of the earliest date of service.
- COMAR 10.09.36.06 — Billing Time Limitations
“The Department may not reimburse the claims received by the Program for payment more than 12 months after the date of service.”
Massachusetts (MassHealth): notes and source
- The shortest limit on this table. A practice billing MassHealth on a monthly cycle is already late.
- 130 CMR 450.309 — Time Limitation on Submission of Claims: General Requirements
“all claims must be received by the MassHealth agency within 90 days from the date of service or the date of the explanation of benefits from another insurer”
Mississippi: notes and source
- Medicare filed timely: the Medicaid claim is processed within 180 calendar days of notice of the Medicare disposition.
- A provider who misses the limit cannot bill the beneficiary.
- Mississippi Division of Medicaid, Administrative Code Title 23, Part 200, Rule 1.6 Timely Filing (effective 1 January 2024)
“The Division of Medicaid requires providers to submit claims no later than three hundred sixty-five (365) calendar days from the date of service.”
Missouri (MO HealthNet): notes and source
- Medicare crossovers: 12 months from the date of service or 6 months from the Medicare notice of the allowed claim.
- 13 CSR 70-3.100 — Filing of Claims, MO HealthNet Program
“Claims from participating providers that request MO HealthNet reimbursement must be filed by the provider and received by the state agency within twelve (12) months from the date of service.”
New Jersey: notes and source
- EPSDT claims are the exception: 30 days from the provision of services.
- Medicare crossovers adjudicated after the year: within 90 days of the Medicare adjudication.
- N.J.A.C. 10:49-7.2 — Timeliness and method of Medicaid claim or other claim submission
“One year of the date of service”
New Mexico: notes and source
- With another payer first: 90 days from that payer's payment or denial, never more than 210 days from the date of service.
- 8.302.2.11 NMAC — Billing and Claims Filing Limitations
“Claims for services must be received within 90 calendar days of the date of service unless an alternative filing limit is stated within this section.”
New York (eMedNY): notes and source
- After 90 days a claim needs a delay-reason statement and must arrive within 30 days of the cause being resolved; everything must be finally submitted and payable within two years.
- 18 NYCRR 540.6 — Billing for medical assistance
“must be initially submitted within 90 days of the date the medical care, services or supplies were furnished to an eligible person to be valid and enforceable against the department or a social services district”
North Carolina (NCTracks): notes and source
- NC Medicaid — Claims and Billing
“Medicaid claims, except inpatient claims and nursing facility claims, must be received by NCTracks within 365 days of the first date of service to be accepted for processing and payment.”
Ohio: notes and source
- Claims through the automatic Medicare crossover are not subject to this rule; eligibility-delay and third-party-reversal claims get 180 days.
- Ohio Admin. Code 5160-1-19 — Submission of medicaid claims
“Claims are timely if received by ODM within: (a) Three hundred sixty-five days of the actual date the service was provided.”
Oklahoma (SoonerCare): notes and source
- Medicare coinsurance/deductible claims: within 90 days of notice of the Medicare disposition.
- OAC 317:30-3-11 — Timely filing limitation
“Payment will not be made on claims when more than 6 months have elapsed between the date the service was provided and the date of receipt of the claim by the Fiscal Agent.”
Pennsylvania: notes and source
- Nursing facilities and ICF/MR count from the last day of the billing period instead.
- 55 Pa. Code § 1101.68 — Invoicing for services
“A provider shall submit original or initial invoices to be received by the Department within a maximum of 180 days after the date the services were rendered or compensable items provided.”
Tennessee (TennCare): notes and source
- Retroactive eligibility: 1 year after the final eligibility determination. Medicare crossovers that do not cross automatically: 6 months from the Medicare notice.
- TennCare is delivered through managed-care organisations, whose contracts set the limit that applies to most claims; this is the rule in the regulation.
- Tenn. Comp. R. & Regs. 1200-13-13-.08 — Providers
“All claims must be filed within one (1) year of the date of service except in the following circumstances:”
Texas: notes and source
- Medicare-processed claims: within 95 days of the Medicare disposition or the final Medicare appeal decision.
- 1 Tex. Admin. Code § 354.1003 — Time Limits for Submitted Claims
“Claims from all other providers delivering services reimbursed by the Texas Medicaid acute care program must be received by HHSC or its designee within 95 days from each date of service on the claim or 95 days from the date the Texas Provider Identifier (TPI) Number is issued, whichever occurs later.”
Washington (Apple Health): notes and source
- A claim only counts as filed when the agency has assigned it a transaction control number.
- Medicare paid first: bill the agency within six months of the Medicare processing date.
- WAC 182-502-0150 — Time limits for providers to bill the agency
“Providers must submit the initial claim to the agency and have a transaction control number (TCN) assigned by the agency within three hundred sixty-five calendar days from any of the following:”
Not yet quoted, because the agency’s document could not be read from here on 2026-09-11 or carried no filing rule: Alaska, Arkansas, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Kansas, Louisiana, Maine, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming. Search snippets say “365 days” for most of them; a snippet is not a source, so they stay off the table until the regulation is read. Each state’s agency is linked from Medicaid by state.
Not listed, on purpose
- Blue Cross Blue Shield plans. Thirty-odd independent licensees, each with its own limit and its own manual. A single row would be wrong for most of them.
- State Medicaid programs. Set by each state agency and its managed-care plans. Twenty-one states' fee-for-service limits, and the federal floor, are quoted from the regulations in the section above; the rest are listed there as not yet read. Medicaid by state →
Sources read 2026-09-10. Your participation agreement overrides a payer’s general policy; the document linked on each row governs any individual claim. Working guidance, not legal advice.
Questions
What is a timely filing limit?
The number of days after the date of service (or discharge) by which the payer must receive the claim. Miss it and the claim is denied — reason code CO-29 — and, under most contracts and under Medicare, the provider absorbs the amount and cannot bill the patient.
Does the clock start when I send the claim or when the payer receives it?
Receipt. UnitedHealthcare’s page says the claim “must be received”; Medicare’s rule is that the claim is filed with the MAC no later than one calendar year after the date of service. A clearinghouse acceptance report with a date is the proof that it was received, which is why that report is kept, not just the claim.
Is a timely filing denial appealable?
For Medicare, no: CMS states that a denial for untimely filing is not an initial determination and is not subject to appeal, and the only routes are the exceptions in 42 CFR 424.44(b). For commercial payers it is usually a reconsideration with proof of timely submission — the acceptance report or the payer’s own rejection history showing the claim was there in time.
What about corrected claims and secondary claims?
It depends on the payer and the source says which. UnitedHealthcare counts corrected claims inside the same window as the original. Cigna measures a secondary claim from the processing date on the primary payer’s EOB, and treats a resubmission it did not request as subject to the limit. Medicare has no separate rule: the date of service governs.
Why does this table not list Aetna’s or UnitedHealthcare’s number?
Because they do not publish one. Both send you to your participation agreement, and a number printed here would be somebody’s contract, not the payer’s policy. The calculator takes the figure from your agreement instead.
Where do these figures come from?
Each row quotes the payer’s own public document, linked, as read on 2026-09-10. Payer policy changes; the document behind the quote is the authority for any individual claim, and your own agreement overrides a general policy.
Keep going
- CO-29: the time limit for filing has expiredWhat to do when it has already happened
- Prompt pay laws by stateThe clock that runs the other way: how long the payer has to pay you
- Denial code lookupAny reason or remark code, official text and the first thing to check
- A seat that never lets a claim ageOne named person, full time, on your queue
The tool answers one question. A seat answers the queue.
Next step
Claims age because nobody owns the queue
A denial management seat works the aging report every working day, so timely filing is a date on a calendar and not a write-off. Twenty minutes on a call is enough to tell whether it pays for itself.
Or write to ops@softhomeglobal.com