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Timely Filing Limits
How long you have to submit a claim, for the programs whose limits are set in federal rules or the payer's own published notice.
| Payer | Limit | Notes |
|---|---|---|
| Medicare (Original Medicare) | 12 months from date of service | One calendar year after the date of service. (42 CFR 424.44) |
| Medicaid (any state) | Up to 12 months from date of service | Federal maximum for an initial claim; many states set a shorter limit. (42 CFR 447.45(d)) |
| TRICARE | 1 year from date of service | Or one year from the date of discharge for inpatient care. (32 CFR 199.7(d)) |
| Aetna (nonparticipating providers) | 12 months from date of service | Medical claims, effective January 1, 2022. Participating providers follow their contract. (Aetna notice, 2021) |
For plans you are contracted with, the limit is in your provider agreement or the plan's provider manual. Check it before you rely on a longer window.
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Source: 42 CFR 424.44 (Medicare) · 42 CFR 447.45 (Medicaid) · 32 CFR 199.7 (TRICARE) · Aetna notice: nonparticipating timely filing change. Updated October 30, 2026. Not affiliated with CMS or any payer.