Timely Filing Limits by Insurance Company (2026)
Medicare: 12 months from date of service. Medicare Advantage: 365-day CMS floor, plan rules vary. Medicaid: varies by state (90 days to 12 months). Commercial payers: typically 90–180 days — UnitedHealthcare 90 days, Aetna 120 days, Cigna 90 days in-network, Humana 90 days. Claims received late are denied CO-29 and are generally not billable to the patient. Your provider contract can override every number on this page — always verify against your contract and the payer's current provider manual.
Deadline checker
Pick the payer and enter the date of service — get your exact filing deadline and days remaining. Add a denial date to see the appeal deadline too.
Based on standard published payer policy (July 2026). Your provider contract or the member's specific plan can override these limits — always verify before relying on a deadline.
| Payer | Plan type | Initial claim limit | Appeal deadline | Notes |
|---|---|---|---|---|
| Government payers | ||||
| Medicare Part A & B (FFS) | Original Medicare | 12 months from DOS | Redetermination: 120 days from remittance | 42 CFR §424.44 — receipt date controls, not postmark |
| Railroad Medicare | FFS | 12 months from DOS | 120 days | Follows CMS rules; billed to Palmetto GBA |
| Medicare Advantage (all carriers) | MA — CMS minimum | 365 days (CMS floor) | 60 days minimum | Plans may allow more, never less; check the specific plan |
| TRICARE (East & West) | Military | 12 months from DOS | 90 days from EOB | Inpatient: 12 months from discharge |
| VA Community Care (CCN) | Veterans | 180 days from DOS | Per Optum/TriWest region rules | Submit via the CCN administrator for your region |
| CHAMPVA | Veterans' family | 12 months from DOS | 1 year from denial | Inpatient: 12 months from discharge |
| National commercial payers | ||||
| UnitedHealthcare | Commercial | 90 days from DOS | 65 days from denial | Shortest appeal window among major payers — contract may vary the claim limit |
| UnitedHealthcare | Medicare Advantage | 365 days | 60 days | Combined reconsideration + appeal must finish within 12 months |
| UnitedHealthcare Community Plan | Medicaid MCO | Varies by state (often 90–120 days) | Per state plan | Check the state-specific UHC Community Plan manual |
| Aetna | Commercial | 120 days from DOS | 180 days from denial | Some employer plans allow up to 1 year — verify per plan |
| Aetna | Medicare Advantage | 120 days (contracts vary, up to 1 year) | 60 days | Verify against your Aetna MA participation agreement |
| Cigna | Commercial in-network | 90 days from DOS | 180 days from denial | California: 365 days by state law; COB claims 90 days from primary EOB |
| Cigna | Out-of-network | 180 days from DOS | 180 days | Submission-log documentation may be requested |
| Cigna (HealthSpring) | Medicare Advantage | Through Dec 31 of the following year | 65 days | Oct–Dec dates of service get an additional calendar year |
| Humana | Commercial | 90 days (par) / 180 days (non-par) | 180 days | Contract terms control for participating providers |
| Humana | Medicare Advantage | 365 days (CMS floor) | 65 days | Humana applies a uniform 65-day appeal window on MA |
| Kaiser Permanente | Commercial / HMO | 90 days (varies by region, up to 12 months) | Per regional manual | Rules differ across Kaiser regions — verify your region's manual |
| Ambetter (Centene) | Marketplace | 180 days from DOS | Per state plan (typically 180 days) | State-specific manuals may differ |
| WellCare (Centene) | Medicare / Medicaid | 180 days from DOS | Per plan | MA plans cannot be shorter than the CMS 365-day floor |
| Molina Healthcare | Medicaid / Marketplace | 90–365 days by state | Per state plan | Verify the state-specific Molina provider manual |
| Oscar Health | Marketplace | 90 days from DOS | Per plan documents | Confirm in the Oscar provider manual for your market |
| GEHA | Federal employees (FEHB) | 12 months (by end of following calendar year) | Per FEHB brochure | FEHB plans follow OPM brochure terms |
| UMR (UHC TPA) | Self-funded employer plans | Commonly 12 months — plan-specific | Per plan document | Each employer plan sets its own terms; check the member ID card / plan doc |
| Meritain Health (Aetna TPA) | Self-funded employer plans | Plan-specific (often 12 months) | Per plan document | Verify per employer plan document |
| Magellan / Carelon Behavioral | Behavioral health | 60–90 days depending on plan | Per plan | Behavioral carve-outs often have shorter windows — verify per contract |
| Blue Cross Blue Shield plans (vary by state) | ||||
| Anthem BCBS (14 states) | Commercial | 90 days from DOS (typical) | 180 days | Contract and state law can extend — verify your state's Anthem manual |
| BCBS Texas (HCSC) | Commercial | 95 days from DOS (some PPO contracts up to 365) | 120 days from RA | Published sources conflict on TX PPO — treat 95 days as the safe rule and verify your contract |
| BCBS Massachusetts | Commercial | 90 days from DOS | Per provider manual | Reduced to 90 days effective Dec 1, 2024 — a common trap for stale trackers |
| BCBS North Carolina | Commercial | 365 days from DOS | Per provider manual | MA plans generally follow the same window |
| Premera Blue Cross (WA/AK) | Commercial | 365 days from DOS | Per provider manual | All appeals via a single fax line since Dec 30, 2025 |
| BCBS Federal Employee Program (FEP) | FEHB | By Dec 31 of the year after the year of service | Per FEP brochure | Uniform nationwide — refreshing consistency for a Blue plan |
| BCBS Alabama | Commercial | Up to 2 years (sources also cite 180 days by plan) | Per provider manual | Published figures conflict — confirm with your BCBS AL contract before relying on the longer window |
| BCBS Wyoming | Commercial | 60 days from DOS (published) | Per provider manual | Among the shortest published windows anywhere — verify and file immediately |
| Highmark BCBS (PA/WV/DE/NY) | Commercial | 365 days (commonly published) | Per provider manual | Verify per state and product |
| Horizon BCBS New Jersey | Commercial | 180 days (commonly published) | Per provider manual | Verify against your Horizon participation agreement |
| CareFirst BCBS (MD/DC/VA) | Commercial | 365 days (commonly published) | Per provider manual | Verify per product line |
| BCBS Illinois / OK / NM / MT (HCSC) | Commercial | 180 days from DOS | 180 days | HCSC states other than Texas commonly allow 180 days |
| Florida Blue | Commercial | 12 months (participating) | Per provider manual | Non-par and plan-specific terms differ |
| Blue Shield of California | Commercial | 12 months from DOS | 365 days | California law sets provider-friendly minimums |
| Other BCBS state plans | Commercial | Varies: 90 days–2 years by state | Varies | Each Blue plan is independent — always check your local plan's provider manual |
| Regional & other payers | ||||
| Fidelis Care (NY) | Medicaid / Marketplace | 90 days from DOS (commonly published) | Per provider manual | Verify current Fidelis manual |
| CareSource (OH/IN/GA/KY/WV) | Medicaid / Marketplace | 365 days (commonly published) | Per state plan | Verify per state product |
| Tufts Health Plan (Point32) | Commercial | 90 days from DOS (commonly published) | Per provider manual | Point32Health rules — verify per product |
| Harvard Pilgrim (Point32) | Commercial | 90 days from DOS (commonly published) | Per provider manual | Point32Health rules — verify per product |
| AvMed (FL) | Commercial | 12 months (commonly published) | Per provider manual | One of the longer commercial windows |
| McLaren Health Plan (MI) | Commercial / Medicaid | 12 months (commonly published) | Per provider manual | Verify per product |
| AmeriHealth Caritas | Medicaid MCO | 180 days (varies by state) | Per state plan | Each state contract differs — verify |
| Aetna Better Health | Medicaid MCO | Varies by state (often 180 days) | Per state plan | State-specific manuals control |
| Optum / United Behavioral Health | Behavioral health | 90 days (commonly published) | Per plan | Behavioral carve-out windows are often shorter than medical |
| Devoted Health | Medicare Advantage | 365 days (CMS floor) | 60 days | MA-only carrier — CMS minimums apply |
| SCAN Health Plan | Medicare Advantage | 365 days (CMS floor) | 60 days | MA-only carrier — CMS minimums apply |
| Alignment Health / Clover Health | Medicare Advantage | 365 days (CMS floor) | 60 days | MA-only carriers — CMS minimums apply |
| Workers' comp & auto/PIP | Property & casualty | Set by state statute — varies widely | Per state process | Not governed by health-plan rules; check the state WC board / no-fault statute |
| State Medicaid programs (fee-for-service) | ||||
| California (Medi-Cal) | Medicaid FFS | 6 months (billing limit); up to 12 with delay reason code | Per DHCS rules | MCO plans set their own limits — verify per plan |
| Texas Medicaid | Medicaid FFS | 95 days from DOS | 120 days from R&S date | TMHP rules; MCOs generally mirror 95 days |
| Florida Medicaid | Medicaid FFS | 12 months from DOS | Per AHCA rules | SMMC plan limits vary — check each MCO manual |
| New York Medicaid | Medicaid FFS | 90 days from DOS | Per eMedNY rules | Exceptions require delay reason codes |
| Pennsylvania Medical Assistance | Medicaid FFS | 180 days from DOS | Per DHS rules | CHC/HealthChoices MCOs set their own limits |
| Illinois Medicaid (HFS) | Medicaid FFS | 180 days from DOS | Per HFS rules | HealthChoice Illinois MCOs vary |
| Ohio Medicaid | Medicaid FFS | 365 days from DOS | Per ODM rules | Next Generation MCO limits may differ |
| Georgia Medicaid | Medicaid FFS | 6 months from DOS | Per DCH rules | Good-cause exceptions documented case-by-case |
| North Carolina Medicaid | Medicaid FFS | 365 days from DOS | Per NCDHHS rules | Standard Plans (MCOs) may differ |
| Michigan Medicaid | Medicaid FFS | 12 months from DOS | Per MDHHS rules | MCO limits vary by plan |
| New Jersey Medicaid | Medicaid FFS | 180 days from DOS | Per DMAHS rules | Documented exceptions can extend to 12 months |
| Virginia Medicaid | Medicaid FFS | 12 months from DOS | Per DMAS rules | Cardinal Care MCOs may differ |
| Washington Apple Health | Medicaid FFS | 365 days from DOS | Per HCA rules | MCO limits vary by plan |
| Arizona (AHCCCS) | Medicaid | 6 months initial (clean claim within 12) | Per AHCCCS rules | Health plan contracts control for MCO members |
| Massachusetts (MassHealth) | Medicaid FFS | 90 days from DOS | Per EOHHS rules | One of the shortest state windows — file fast |
| Indiana Medicaid (IHCP) | Medicaid FFS | 180 days from DOS | Per IHCP rules | MCE plans may differ |
| Tennessee (TennCare) | Medicaid managed care | 120 days from DOS (commonly published) | Per MCO | Fully managed-care state — each MCO manual controls |
| Colorado (Health First Colorado) | Medicaid FFS | 365 days from DOS | Per HCPF rules | RAE/MCO limits may differ |
| Wisconsin (ForwardHealth) | Medicaid FFS | 365 days from DOS | Per DHS rules | HMO limits vary by plan |
| Oklahoma (SoonerCare) | Medicaid FFS | 6 months from DOS | Per OHCA rules | SoonerSelect MCO limits may differ |
| Kentucky Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per DMS rules | MCO limits vary — verify per plan |
| Louisiana Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per LDH rules | Healthy Louisiana MCO limits vary |
| Minnesota Medical Assistance | Medicaid FFS | 12 months from DOS (commonly published) | Per DHS rules | MCO limits vary |
| Missouri (MO HealthNet) | Medicaid FFS | 12 months from DOS (commonly published) | Per DSS rules | Managed care limits vary |
| South Carolina (Healthy Connections) | Medicaid FFS | 12 months from DOS (commonly published) | Per SCDHHS rules | MCO limits vary |
| Alabama Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per agency rules | Verify current agency billing manual |
| Arkansas Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per DHS rules | PASSE plan limits may differ |
| Oregon Health Plan | Medicaid FFS | 12 months from DOS (commonly published) | Per OHA rules | CCO limits vary by plan |
| Nevada Medicaid | Medicaid FFS | 180 days from DOS (commonly published) | Per DHCFP rules | MCO limits vary |
| Maryland Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per MDH rules | HealthChoice MCO limits vary |
| Connecticut (HUSKY Health) | Medicaid FFS | 12 months from DOS (commonly published) | Per DSS rules | Verify current CMAP manual |
| Iowa Medicaid | Medicaid FFS | 365 days from DOS (commonly published) | Per HHS rules | Iowa Health Link MCO limits vary |
| Utah Medicaid | Medicaid FFS | 12 months from DOS (commonly published) | Per DHHS rules | ACO plan limits vary |
| District of Columbia Medicaid | Medicaid FFS | 365 days from DOS (commonly published) | Per DHCF rules | MCO limits vary |
| Other state Medicaid programs | Medicaid | Typically 90 days–12 months | Per state | Remaining states (AK, DE, HI, ID, KS, ME, MS, MT, NE, NH, NM, ND, RI, SD, VT, WV, WY) — verify the state manual and each MCO's provider manual; we track all of them for our clients |
Disclaimer: Limits above reflect standard published payer policies as of July 2026. Your provider participation agreement, the member's specific plan, and state law can all override these numbers — in either direction. Before relying on any deadline, verify against your contract and the payer's current provider manual. If we manage your billing, we track every payer deadline for you automatically.
When does the timely filing clock actually start?
This is where most avoidable CO-29 denials come from. The clock start depends on claim type:
Professional claims: the date of service. Institutional inpatient claims: usually the date of discharge. Secondary / COB claims: most payers restart the clock from the primary payer's EOB or remittance date — Cigna, for example, allows 90 days from the primary EOB. Corrected claims: many payers measure corrected-claim windows from the original remittance date, not the DOS — and a corrected claim does not reset the original timely filing window.
Equally important: Medicare and most payers count the receipt date, not the submission or postmark date. A claim mailed on the deadline that arrives three days later is late. Electronic submission with a clearinghouse acceptance report removes this ambiguity entirely.
Denied CO-29? Here's what proof actually wins the appeal
A CO-29 denial means the payer says your claim arrived late. It is one of the most winnable denial types — if you have documentation. Payers generally accept, in descending order of strength: an EDI clearinghouse acceptance report showing the payer received the original claim in the window; a payer claim number or acknowledgment from the original submission; certified mail receipts for paper claims; and screenshots of portal submission confirmations with timestamps.
Payers also recognize exceptions where late submission wasn't your fault: retroactive eligibility (the patient's coverage was granted after the DOS), coordination-of-benefits delays (you were waiting on the primary payer), documented payer processing errors, and in some states, declared disasters. "We were short-staffed" is not an accepted exception anywhere.
For the full appeal workflow, see our guide to the CO-29 denial code and the top 10 denial codes. If your team doesn't have time to fight these, that's literally what our denial management service exists for.
How to never miss a filing window again
Practices that eliminate timely filing denials all do the same four things. First, they submit daily — not weekly batches — so no claim ever ages near a deadline. Second, they track deadlines per payer, not with one generic rule; a MassHealth 90-day window and a Medicare 12-month window cannot live on the same calendar reminder. Third, they keep clearinghouse acceptance reports for every submission, so any CO-29 is appealable with proof. Fourth, they work rejections within 48 hours, because a rejected claim was never "received" — the clock keeps running while it sits in a work queue.
Or they outsource the problem. Our billing team submits claims within 24–48 hours of charge capture, tracks every payer's window automatically, and appeals CO-29 denials with submission proof — and because we're paid on collections, a claim that dies from late filing costs us too. That's the point of percentage-based pricing.
Timely filing FAQs
What is the timely filing limit for Medicare in 2026?
Medicare Part A and Part B claims must be received within 12 months (1 calendar year) from the date of service, under 42 CFR 424.44. Medicare uses the receipt date, not the postmark date. Medicare Advantage plans set their own limits, with a CMS floor of 365 days for claim submission.
What is the timely filing limit for UnitedHealthcare?
UnitedHealthcare commercial plans generally require claims within 90 days from the date of service for participating providers, though individual contracts can differ. UHC Medicare Advantage allows 365 days. UHC appeal deadlines are unusually short: 65 days for commercial plans and 60 days for Medicare Advantage.
What does timely filing limit mean in medical billing?
A timely filing limit is the maximum time a payer allows between the date of service and receipt of the claim. Claims received after the deadline are denied with reason code CO-29, and the balance generally cannot be billed to the patient. Each payer sets its own limit, and provider contracts can override the standard published limit.
Can you appeal a timely filing denial (CO-29)?
Yes, if you can prove the claim was originally submitted on time. The strongest evidence is an EDI clearinghouse acceptance report showing the payer received the claim within the window. Retroactive eligibility, coordination-of-benefits delays with a primary payer, and documented payer processing errors are also accepted exceptions by most payers.
Does the timely filing clock start from the date of service or date of discharge?
For professional claims the clock starts on the date of service. For institutional inpatient claims it usually starts on the date of discharge. For secondary claims after coordination of benefits, most payers restart the clock from the primary payer's EOB or remittance date — commonly 90 days from the primary EOB.
Are appeal deadlines the same as timely filing limits?
No. The timely filing limit governs the original claim submission, measured from the date of service. Appeal deadlines govern how long you have to contest a denial, measured from the denial or remittance date. They are tracked separately: for example, UnitedHealthcare allows 90 days to file a commercial claim but only 65 days to appeal a denial.
Find out how much late filing is costing you
Request a free billing audit — we'll review your denial history, flag CO-29 losses that are still appealable, and show you exactly where revenue is leaking. No obligation.
