Timely Filing Calculator & Limits by Payer (2026)

A timely filing limit is the last day a payer will accept a claim for a date of service. Medicare's is 12 months (one calendar year) from the date of service; commercial plans are often much shorter, commonly 90 or 180 days, and the number in your participation agreement overrides the payer's default. Miss it and the claim is denied with no payment from the payer, and in-network you generally can't bill the patient either.

Enter a date of service below to see each payer's deadline and the days you have left. Every default limit in the list comes from the payer's own manual or rules page, verified on the date at the top of this page. Add your own contracted limits for any other payer.

Timely filing limits by payer

These are the default limits each payer publishes for professional claims. Your contract or state law can set a different number, and several payers say so explicitly.

UnitedHealthcare's 2026 guide doesn't publish one commercial number: it tells you to "refer to your Agreement" and illustrates the rule with a 90-day limit. For Medicaid, the federal rule caps the window at 12 months from the date of service and many states set a shorter one, so look up your state's provider manual. Medicare Advantage plans and Blue Cross Blue Shield plans set limits plan by plan; use your contract and add it to the calculator.

How Medicare counts timely filing

The Medicare rule sounds simple, one calendar year, but the start date depends on the claim type (Chapter 1, §70.1):

• Professional claims (CMS-1500 / 837P): the clock starts on each line's "From" date. If a line spans dates and the "From" date is late but the "To" date isn't, the contractor splits the line and denies only the untimely days.
• Institutional claims (CMS-1450 / 837I) with a date span: the clock starts on the "Through" date.
• Leap day: a claim with a date of service of February 29 must be filed by February 28 of the next year.

The end date is the day the correct Medicare contractor receives the claim. Submissions that fail front-end edits for missing or invalid data are returned and "are not considered claims," so the clock keeps running while you fix them.

Worked example

A visit on March 16, 2026 has a Medicare deadline one year later. If you're also secondary-billing a Cigna in-network plan, its 90-day window closes much sooner, which is why the shortest deadline on the account is the one that drives your work queue.

Exceptions that extend Medicare's deadline

42 CFR 424.44(b) allows four exceptions, described in Chapter 1, §70.7:

1. Administrative error by Medicare or its contractor caused the late filing. The limit extends through the last day of the sixth calendar month after the month the error is corrected, and not beyond four years from the date of service.
2. Retroactive Medicare entitlement, where the patient is notified of entitlement back to or before the date of service.
3. Retroactive entitlement involving a state Medicaid agency that recoups its payment 6 months or more after the date of service.
4. Retroactive disenrollment from a Medicare Advantage plan or PACE organization that recoups its payment 6 months or more after the date of service.

Outside those exceptions, a late claim is denied, and the denial "does not constitute an 'initial determination'" so it isn't appealable. If the provider is responsible for the late filing, it can't charge the patient beyond the deductible and coinsurance they would have owed.

Corrected claims, reopenings and appeals

Deadlines don't end at first submission. Each payer sets separate windows for fixing and disputing claims:

• Medicare reopenings: a contractor can reopen a processed claim within 1 year of the initial determination for any reason, or within 4 years for good cause (Chapter 34). You can't add a service you forgot to bill once the original filing limit has passed.
• Medicare redeterminations: 120 days from receipt of the initial determination, which is presumed to be 5 days after the notice date (CMS first-level appeal).
• UnitedHealthcare corrected claims: must arrive within the same timely filing limit as the original, counted from the date of service. Reconsiderations and appeals: 12 months from the original EOB or PRA, unless law or your Agreement says otherwise.
• Cigna secondary claims: when Cigna is secondary, the limit runs from the primary payer's EOB processing date.

How to stay inside timely filing limits

1. Record every payer's limit in your practice management system. Use the contracted number, not a blog's table, and recheck it at each contract renewal.
2. Work by the shortest deadline. Sort open claims by days left, not by date of service.
3. Clear rejections the same day. A rejection doesn't stop the clock.
4. Keep proof of filing. Save clearinghouse acceptance reports (999 and 277CA) showing the payer received and accepted the claim. Payers ask for the submission date, acceptance date, member ID, date of service and provider ID.
5. Bill secondary payers promptly. Most count secondary limits from the primary's EOB date, but only if you send it.

Timely filing denials show up on remittances as claim adjustment reason code 29, "The time limit for filing has expired" (X12 CARC list), usually with group code CO.