Timely filing limits: Medicare and state Medicaid
Look up the time limit for submitting an original claim to Medicare or to a state's Medicaid fee-for-service program, counted from the date of service. Every row names the rule or provider manual it was read from, with its official address and the date it was read. Medicare and all 51 Medicaid programs have a row; a program that has not been read is listed separately instead of being guessed. Pick a program and a date of service to see the last day its limit reaches.
Your file never leaves this computer. It is read and processed inside this page, which is built so it cannot make network requests. It keeps working with your internet turned off.
What the table shows
Worked out from the rows above each time the page loads, each figure counted a second way. Only the members with a row are counted.
Not yet covered
These programs have not been read from an official source yet. Missing means not checked yet, not "no limit".
Last day a row's limit reaches
Arithmetic on the row: the count starts the day after the date of service (or after the month of service, where the row says so). It does not apply the exceptions in the row's notes.
Figures and dates only, from the cited rules and manuals; not legal or billing advice, and commercial payers are not covered. Mathproven is not affiliated with any agency whose rules are cited here.
What gets checked
- The last day is worked out twice: once with the site's calendar helpers and once on a separate whole-number calendar; both must give the same day.
- The days between the as-of date and the last day are counted a second way by day numbers, and counting back that many days from the last day must land on the as-of date.
- The limit used is the one in the table row for the chosen program, with its citation.
- A warning shows when the date of service has no matching day in the month the count ends in (January 31 plus one month), because the count then ends on that month's last day.
- Every row in the table names its rule or manual, gives an official address and the date it was read, and every Medicaid row is no longer than the 12 months federal rule 42 CFR 447.45(d)(1) allows. Automated tests fail the build if one is missing.
How it works
- Find the program. Type a state name, a code, or a citation in the filter, or click a column heading to sort. Each row shows the limit as the source states it (days, months, or a year), where the count starts, short notes on other claim types and exceptions, and the source.
- Read the source. Each row gives the rule or manual section, the official address it was read on, and the date it was read, so the wording can be checked in full.
- Work out the last day. Pick a program, enter a date of service, and set the as-of date. The page shows the last day the row's limit reaches and how many days the as-of date is from it, with the checks.
- Read what the table shows. Below the table, a few sentences are worked out from the rows each time the page loads: the most common limit, the shortest and longest, and where the counts start. Each figure is counted a second way, with its own check.
Worked example
A made-up date of service, March 10, 2026, looked at on an as-of date of October 19, 2026, for three rows.
| Program | Row's limit | Last day the limit reaches | From the as-of date |
|---|---|---|---|
| Medicare | 1 year from the date of service | March 10, 2027 | 142 days after |
| New York Medicaid | 90 days from the date of service | June 8, 2026 | 133 days before |
| South Dakota Medicaid | 6 months after the month of service | September 30, 2026 | 19 days before |
One calendar year after March 10, 2026 is March 10, 2027, 142 days after October 19, 2026; counting back 142 days from March 10, 2027 lands on October 19, 2026, so the check passes. 90 days after March 10, 2026 is June 8, 2026, 133 days before the as-of date. The six months following March 2026 end on September 30, 2026, 19 days before the as-of date.
The example uses made-up names and numbers.
Questions
Is every state covered?
Yes. Medicare and all 51 Medicaid programs (the 50 states and the District of Columbia) have a row, each read on an official site: the state's statutes, administrative code, or the Medicaid agency's own provider manual. A program without such a reading would be listed under Not yet covered instead of being guessed.
Does the row's limit apply to every claim?
No. The row holds the general limit for an original professional claim. Inpatient, nursing facility, pharmacy, Medicare crossover, other-insurance, and retroactive eligibility claims often have their own limits or starting points; the notes summarize what the source says about them.
How is the last day counted?
The day after the date of service is day 1. A limit in days ends that many days later; a limit in months or years ends on the same day of the month that many months or years later, or on the month's last day when it is shorter. For California, Georgia and South Dakota, the six months after the month of service end on the last day of the sixth month after the month of service. Where a source moves a deadline that falls on a weekend or holiday, the row's note says so; the calculator does not move it.
Are commercial payers or Medicaid managed care plans included?
No. Their limits are set in contracts and plan manuals rather than in public rules, so this table covers only Medicare and the states' fee-for-service programs.
Is anything I enter sent anywhere?
No. This page is served with a policy that blocks every kind of network request from the page. The table is part of the page, and the dates you enter stay in this browser tab.
This tool calculates and checks numbers. It is not legal, tax, or medical advice.