Medicare Appeals Deadline Calculator

Which decision are you appealing?

Date printed on the notice

Use the date on the notice itself, not the day it reached you. The calculator adds the presumed receipt period for you — that is the part most people miss.

Appeal deadline

Days remaining

Pick the level and enter the date on the notice.

The Five Levels, and Why the Clock Differs

Medicare appeals run through five levels, and each one has its own filing window. Treating them as a single “appeal deadline” is how practices miss them — the 120 days you had at the first level becomes 60 days by the third, and nothing warns you.

Level	Decided by	Filing window
1. Redetermination	Your MAC	120 days from receipt of the initial determination
2. Reconsideration	A Qualified Independent Contractor	180 days from receipt of the redetermination
3. ALJ hearing	Office of Medicare Hearings and Appeals	60 days from receipt of the reconsideration
4. Appeals Council	Medicare Appeals Council	60 days from receipt of the ALJ decision
5. Judicial review	Federal District Court	60 days from receipt of the Council decision

Levels 3 and 5 also carry an amount in controversy threshold — the claim has to be worth enough to justify the forum. Those figures are indexed and published annually, so check the current amount before planning an ALJ appeal on a small-dollar claim. Small claims can often be aggregated to reach the threshold.

The Five Days Nobody Counts

The clock runs from receipt, not from the date on the notice — and receipt is presumed to be five days after that date unless you can show otherwise.

That sounds like a technicality until a filing lands on day 121. Counting from the notice date makes you five days early, which costs nothing. Counting from the day it physically arrived, with no evidence of when that was, makes you five days optimistic — and the contractor counts from the presumption, not from your recollection.

This calculator applies the five days for you. If you have proof of a later delivery date, you may have longer, but build the plan around the presumption and treat anything extra as a buffer.

A Late Appeal Is Not Always Dead

Medicare allows late filing for good cause at the first two levels. It is not a formality and it is not granted for being busy, but genuine circumstances — serious illness, a records request that went unanswered, a notice sent to the wrong address — are considered when documented and explained in the request itself.

What does not work is filing late and hoping nobody notices. State the reason, attach what supports it, and ask explicitly for good cause. A request that ignores its own lateness is simply dismissed.

Before You Appeal At All

Check it is actually an appeal. If the claim was wrong when you sent it, a corrected claim is faster and more likely to pay. The claim frequency code tool settles which route applies.

Read the denial properly. A pricing rule such as sequestration or MPPR is not appealable, because nothing went wrong.

Appeal with evidence, not assertion. The appeal letter generator gives you the structure; the records give you the case.

Watch the other clock. Appeal windows are separate from filing windows — check both with the timely filing calculator.

Timely filing & appeal deadline calculator for commercial payers, Medicare billing guide, and appeal letter generator. Programme rules are set federally and revised periodically — confirm current windows and thresholds with your MAC before relying on them for a specific claim.

Frequently Asked Questions

How long do I have to appeal a Medicare claim denial?

120 days from receipt of the initial determination for a redetermination, which is the first level. Receipt is presumed to be five days after the date printed on the notice, so the practical window from the notice date is 125 days.

What are the five levels of Medicare appeal?

Redetermination by your MAC (120 days), reconsideration by a Qualified Independent Contractor (180 days), an ALJ hearing at the Office of Medicare Hearings and Appeals (60 days), the Medicare Appeals Council (60 days), and judicial review in Federal District Court (60 days). Each window runs from receipt of the previous decision.

When does the Medicare appeal clock actually start?

From receipt of the notice, not the date printed on it. Medicare presumes receipt five days after the notice date unless you can demonstrate otherwise, so counting from the notice date leaves you five days early — which is the safe direction to be wrong in.

Can I still appeal after the Medicare deadline has passed?

Possibly, at the first two levels, if you can show good cause. Serious illness, a records request that went unanswered, or a notice sent to the wrong address are the kinds of circumstances considered. You have to raise it explicitly and document it — a late request that does not address its own lateness is dismissed.

Is there a minimum claim value to appeal to an ALJ?

Yes. Levels 3 and 5 carry an amount in controversy threshold, indexed and published annually. Smaller claims can often be aggregated to reach it, so a batch of similar denials may qualify where a single claim would not.

The Five Levels, and Why the Clock Differs

The Five Days Nobody Counts

A Late Appeal Is Not Always Dead

Before You Appeal At All

Related

Frequently Asked Questions

Appeals Piling Up Faster Than You Can Work Them?