Timely Filing Limits by Payer
Original Medicare allows 12 months from the date of service. Commercial payers set the limit in your contract, and the published defaults are 90 to 180 days. Fee-for-service Medicaid runs from 90 days to 12 months, depending on the state.
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The Limits in One Place
These are the published defaults. Your payer contract wins over every number on this page, and so does state law. Check the agreement you signed, then the payer's current provider manual, before you rely on a date.
| Original Medicare | 12 months from the date of service. A late claim cannot be appealed. See the Medicare timely filing limit. |
| Medicare Advantage | Set by the plan contract. CMS gives no single number for contracted providers. |
| Commercial payers | Set by your contract. Published defaults: Cigna 90 days in network and 180 out of network, UnitedHealthcare at least 90 and up to 180 days, Anthem Ohio 90 days for professional claims. Aetna publishes none. |
| Medicaid (fee-for-service) | From 90 days (New York) and 95 days (Texas) to 12 months (Florida, Michigan) and 365 days (Ohio, North Carolina). Managed care plans set their own. |
Medicare and Commercial Payers
Each value was read in the linked source on 5 October 2026.
| Payer | Filing limit | Clock starts | Notes and source |
|---|---|---|---|
| Original Medicare (Part A and B) | 12 months (1 calendar year) | Date of service | Four exceptions, for example contractor error or retroactive entitlement. A late claim cannot be appealed. Source: 42 CFR 424.44. |
| Medicare Advantage plans | Set by the plan contract | Per contract | CMS guidance says the contract governs payment to a contracted provider. We found no single CMS number. UnitedHealthcare states it allows non-contracted providers 365 days from the through date of service. Source: CMS Parts C and D Appeals Guidance (July 2026), s.40; 42 CFR 422.520. |
| UnitedHealthcare | Per your agreement. The guide states at least 90 days (participating) and up to 180 days (non-participating) | Last date of service. As secondary payer: at least 90 days from the primary payer's decision | State law and your agreement can change it. Source: 2026 UnitedHealthcare Care Provider Administrative Guide, Chapter 10. |
| Cigna Healthcare | 90 days (participating), 180 days (out of network) | Date of service, or the last date for consecutive days. As secondary payer: the primary payer's EOB date | Longer periods apply where law or your provider agreement allows. Source: Cigna: When to File (Timely Filing Policy). |
| Aetna | Not published | Not published | No timely filing number in Aetna's public provider manual (rev. 6/26). Check your provider agreement. Source: Aetna Provider Manual (6/26). |
| Anthem Blue Cross and Blue Shield (OH) | 90 days (professional claims) | Date of service. As secondary payer: notice of the primary payer's responsibility | For claims received from 1 October 2019 on affected professional contracts. Facility claims are not covered by this notice. Source: Anthem Provider News Ohio, 1 September 2019. |
State Medicaid Programs
Fee-for-service only. A Medicaid managed care plan sets its own limit in its contract.
| Payer | Filing limit | Clock starts | Notes and source |
|---|---|---|---|
| Medi-Cal (CA) | 6 months after the month of service for full payment. Months 7 to 9: payment cut 25%. Months 10 to 12: cut 50% | The month the service was given | Exceptions can extend to 1 year for causes outside your control. Managed care plans set their own limits. Source: Cal. Welfare and Institutions Code 14115; 22 CCR 51008. |
| New York Medicaid (eMedNY) (NY) | 90 days. Outer limit 2 years with an accepted delay reason | Date of service | For a delay outside your control, submit within 30 days after the claim comes back within your control. Source: eMedNY Guide to Timely Billing. |
| Texas Medicaid (TMHP) (TX) | 95 days (out-of-state providers: 365 days) | Date of service. Inpatient: discharge or last date of service | A deadline on a weekend or holiday moves to the next business day. Source: Texas Medicaid Provider Procedures Manual Vol. 1, 6.1.4 (Oct 2026). |
| Florida Medicaid (AHCA) (FL) | 12 months | Date of service or discharge | Confirmed through an AHCA rule notice only. Medicare crossovers: the greater of 36 months from the date of service or 12 months from Medicare's decision. Source: Florida Administrative Register: AHCA notice, Rule 59G-4.003. |
| Pennsylvania Medical Assistance (PA) | 180 days. Resubmission of rejected claims and adjustments: 365 days from the date of service | Date of service | A late-claim denial generally cannot be appealed unless the Department caused the delay. Source: 55 Pa. Code 1101.68. |
| Illinois Medicaid (HFS) (IL) | 180 days | Date of service. Inpatient: discharge | Applies to initial and resubmitted claims, so a denial does not restart the clock. Source: Illinois HFS Handbook for Providers, Ch. 100, 112.4. |
| Ohio Medicaid (ODM) (OH) | 365 days | Date of service. Inpatient: discharge | Resubmitted denied claims: the same 365 days. Source: Ohio Admin. Code 5160-1-19. |
| Michigan Medicaid (MDHHS) (MI) | 12 months (pharmacy: 180 days) | Date of service. Institutional: the through date | The claim must be received and get a TCN within 12 months. Source: Michigan Medicaid Provider Manual (July 2026), 11.3. |
| North Carolina Medicaid Direct (NC) | 365 days | Date of service. Inpatient: discharge | Third-party liability: 180 days from the other payer's decision. Source: 10A NCAC 22B .0104. |
| Georgia Medicaid (DCH) (GA) | 6 months | End of the month the service was given, not the date of service | Denied for missing or wrong data: the later of 6 months from the month of service or 3 months from the month of denial. Source: Georgia DCH Part I Policies and Procedures (July 2026), 203.1.3. |
Blue Cross Blue Shield. Each of the independent BCBS companies sets its own limit, so there is no one BCBS number. The Anthem row above is for Ohio only. Check the local plan's provider manual and your contract.
When a Claim Comes Back Late, Step by Step
A timely filing denial usually arrives as CO 29, the time limit for filing has expired.
- 1Step 1: Check the date that counts. Most payers count from the date of service, some from the discharge date or the end of the month of service. Use the clock column above.
- 2Step 2: Find proof that you filed on time. A clearinghouse acceptance report or a payer acknowledgment for the first submission. A claim the payer returned as incomplete may not count as filed.
- 3Step 3: Check for an exception. For Medicare: contractor error, retroactive entitlement, and the other exceptions in 42 CFR 424.44(b). For other payers: the exceptions in your contract and the provider manual.
- 4Step 4: Ask for a reconsideration, or write it off. Where the payer allows it, send the proof inside its appeal window. Where it does not, as with Original Medicare, the line is a write-off, and the fix is the filing process.
Need the appeal windows too? The Payer Appeal Deadline Table adds every appeal level for Medicare, Medicare Advantage, these commercial payers and these Medicaid programs, with the source and the checked date on every row.
Your Questions Answered
What are the timely filing limits for the major payers?
Original Medicare allows 12 months from the date of service. Commercial payers set the limit in your contract, and the published defaults are 90 to 180 days. Fee-for-service Medicaid runs from 90 days to 12 months, depending on the state. Your payer contract overrides every published default.
What is the Medicare timely filing limit?
12 months (1 calendar year) from the date of service (42 CFR 424.44). Four exceptions, for example contractor error or retroactive entitlement. A late claim cannot be appealed.
What is the UnitedHealthcare timely filing limit?
Per your agreement. The guide states at least 90 days (participating) and up to 180 days (non-participating). The clock starts on the last date of service. As secondary payer: at least 90 days from the primary payer's decision. State law and your agreement can change it.
What is the Cigna timely filing limit?
90 days (participating), 180 days (out of network). Longer periods apply where law or your provider agreement allows.
What is the Aetna timely filing limit?
No timely filing number in Aetna's public provider manual (rev. 6/26). Check your provider agreement.
What is the timely filing limit for Medicaid?
Each state sets its own limit for fee-for-service Medicaid. CA: 6 months after the month of service for full payment. NY: 90 days. TX: 95 days (out-of-state providers: 365 days). FL: 12 months. PA: 180 days. IL: 180 days. OH: 365 days. MI: 12 months (pharmacy: 180 days). NC: 365 days. GA: 6 months. Medicaid managed care plans set their own limits in their contracts.
Can you appeal a timely filing denial?
For Original Medicare, no: a timely filing determination is not an initial determination (42 CFR 405.926(n)). Only the four exceptions in 42 CFR 424.44(b) extend the time. For other payers, check the contract and the provider manual. Pennsylvania Medicaid, for example, generally does not hear a late-claim appeal unless the Department caused the delay.
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