Timely Filing Limits by Payer 2026: Deadline Guide

Important: the limits below are the commonly published standard timely-filing windows for each payer. Individual provider contracts, plan types (HMO vs. PPO, Medicare Advantage vs. commercial), and state regulations can modify them. Always verify against your specific payer contract before treating a deadline as final.

Timely filing is the least forgiving rule in medical billing. A claim denied for missing information can be fixed and resubmitted. A claim denied for lack of authorization can be appealed. A claim denied for timely filing is, in most cases, simply gone — the payer won't pay, and you typically can't balance-bill the patient for it. That's why the best billing operations treat the filing deadline as the single most important date on every claim.

Timely filing limits by payer

Days are counted from the date of service (or discharge date for inpatient claims) to the date the payer receives the claim — not the date you sent it to your clearinghouse.

Payer	Timely filing limit	Notes
UnitedHealthcare	90 days	One of the tightest commercial windows; some plans allow 90 days from the EOB of the primary payer for secondary claims
NY Medicaid	90 days	Strict; limited exceptions
Aetna	120 days	Standard commercial limit
Cigna	180 days	Standard commercial limit
Anthem BCBS	180 days	Varies by state plan — verify your state
Humana	180 days	Standard commercial limit
Medicare (Parts A & B)	365 days	Set by federal regulation — 12 months from date of service
Self-pay	365 days	No payer deadline, but bill promptly — patient balances age fast

Why claims miss the window

In practice, timely-filing denials rarely come from billers sitting on claims. The usual causes:

Eligibility and coordination-of-benefits delays — the claim bounces while you sort out which payer is primary.
Credentialing gaps — a new provider's claims hold until the payer loads them, and the clock keeps ticking.
Clearinghouse or transmission failures — the claim never actually reached the payer. Without a 277CA acknowledgment proving receipt, you have no defense.
Waiting on documentation — holding a claim for chart notes while the deadline passes. Bill what you can, then send records.
Denial rework queues — a denied claim sits in someone's queue past the corrected-claim deadline.

How to never miss a deadline

Keep a per-payer deadline table — the table above is a starting point; add your contract-specific limits and appeal windows.
Work oldest first — sort claim worklists by days remaining until the filing deadline, not by dollar amount.
Keep proof of every submission — clearinghouse acceptance reports and 277CA claim acknowledgments are your only defense against a wrongful timely-filing denial.
Flag at 50% and 80% of the window — a claim halfway to its deadline with no payer response needs attention, not patience.
Submit secondary claims immediately — the secondary payer's clock often starts from the primary EOB date; don't let it sit.

Can you appeal a timely-filing denial?

Only with proof. If your clearinghouse reports and 277CA acknowledgments show the payer received the claim within the window, submit that proof with an appeal — wrongful timely-filing denials do get overturned. If the claim was genuinely late, appeals are almost never successful, and most payers prohibit billing the patient. The lesson is always the same: prevention beats appeal. For the full appeal process on denials that can be fought, see how to appeal a denied claim.

What counts as "received"?

The deadline runs to the date the payer receives the claim, not the date you transmitted it to your clearinghouse. This distinction matters: a claim sent to the clearinghouse on day 89 for a 90-day payer but delivered to the payer on day 92 is late. The 277CA claim acknowledgment is your evidence of the payer's receipt date — it's the document that proves when the clock stopped. Build your internal deadlines a few days inside the payer's limit to absorb transmission time.

Secondary claims and coordination of benefits

When a patient has two payers, the secondary payer's filing clock typically starts from the date on the primary payer's remittance advice — not the date of service. This is where many secondary claims die: the primary took 60 days to adjudicate, the biller took another 30 to get around to the secondary, and a 90-day secondary window is suddenly gone. The fix is process: secondary claims should go out within days of the primary EOB, automatically, not when someone gets to them.

State Medicaid programs

Medicaid timely-filing limits are set state by state and vary widely — many states allow 6–12 months, but some are much tighter (NY Medicaid's 90 days is among the strictest). If you bill Medicaid in multiple states, maintain a per-state table alongside your per-payer table. State programs also tend to have narrower exception processes, so the margin for error is smaller.

Building your deadline calendar

A payer table is only useful if it's operational. Turn it into a working system:

One row per payer-plan combination — not just "Cigna 180" but "Cigna commercial 180 / Cigna Medicare Advantage 180 / Cigna behavioral health carve-out 90" where they differ. Your contract, not the brochure, is the source of truth.
Two dates per claim: the filing deadline and a warning date 14 days before it. The warning date is what your worklist sorts on.
A weekly "at risk" review: every claim within 14 days of its deadline gets eyes on it, every week, no exceptions. This single meeting prevents more write-offs than any other habit in billing.
Quarterly table review: payer contracts renew and limits change. Re-verify your top 10 payers every quarter.

Illustration of a calendar marked with payer filing deadlines

90–365

Days — the range of timely filing windows across major payers. Miss yours and the claim is uncollectible.

Frequently asked questions

What is timely filing in medical billing?

Timely filing is the deadline each payer sets for receiving an initial claim after the date of service. If the claim arrives after the limit, the payer denies it and the provider generally cannot bill the patient — the revenue is lost.

What is Medicare's timely filing limit?

Medicare requires claims to be filed no later than 12 months (365 days) from the date of service. This is set by federal regulation and is one of the longest standard filing windows in US healthcare.

Can a timely filing denial be appealed?

Only if you can prove the claim was actually submitted on time — with clearinghouse acceptance reports and 277CA acknowledgments showing the payer received it within the window. If the claim was genuinely late, appeals are almost never successful.

Do timely filing limits vary by plan or state?

Yes. Limits can differ between a payer's commercial plans, Medicare Advantage plans, and Medicaid products, and provider contracts can modify the standard limit. Always verify against your specific payer contract, not just the published standard.

How do I track timely filing deadlines?

Work claims oldest-first against a per-payer deadline calendar, keep proof of every submission (clearinghouse reports, 277CA acks), and use a tracker that flags claims approaching their deadline. Automated deadline tracking is one of the highest-ROI functions in a billing operation.