When it comes to billing Medicaid, understanding each state's timely filing limits is non-negotiable. Missing a deadline means denied claims—revenue lost. Medicaid doesn't play, and they certainly don't bend the rules for late submissions. This guide breaks down Medicaid timely filing limits state by state for 2025, ensuring your billing team can stay ahead.
How Timely Filing Limits Work
Timely filing is the period in which a claim must be submitted to Medicaid after the service is provided. Varying from state to state, these deadlines range from 90 days to a full year. But why the discrepancy? States set their own rules, reflecting budget cycles, administrative processes, and policy goals.
Why Deadlines Matter
Miss the deadline, miss the money. Medicaid doesn't entertain pity parties. Once a deadline passes, the chance to collect reimbursement vanishes unless there's a valid reason like payer error. Even then, appeals are uphill battles that often end in frustration rather than resolution.
State-by-State Timely Filing Limits
Alabama to Georgia
Alabama: 365 days. Straightforward, but don't get complacent—denials happen.
Alaska: 12 months from the date of service. Double-check your submission reports to avoid costly oversights.
Arizona: 6 months. Tight, but manageable with efficient workflows.
Arkansas: 12 months. Offers some breathing room, yet vigilance is advised.
California: 180 days for in-state providers. Shorter than many expect—mark your calendars.
Colorado: 365 days. Use the time to ensure accuracy.
Connecticut: 365 days. Consistency is key; track submission dates.
Delaware: 300 days. Not the norm. Plan accordingly.
Florida: 12 months. Take advantage of this generous window.
Georgia: 6 months. Requires quick turnaround—no room for delay.
Hawaii to Maryland
Hawaii: 12 months. A forgiving timeline; maintain good habits.
Idaho: 365 days. Ample time for thorough claims processing.
Illinois: 180 days. Be prompt—delays can be costly.
Indiana: 365 days. Use this time for meticulous documentation.
Iowa: 90 days. The shortest window on the list—stay alert.
Kansas: 12 months. Generous, but don't procrastinate.
Kentucky: 12 months. Consistency in submissions is crucial.
Louisiana: 365 days. Maintain a steady claims flow.
Maine: 120 days. Less time than most; stay organized.
Maryland: 360 days. Enough time if workflows are efficient.
Massachusetts to New York
Massachusetts: 90 days, exceptionally short. Prioritization is essential.
Michigan: 365 days. Plenty of time, but use it wisely.
Minnesota: 365 days. Rewards consistent follow-up.
Mississippi: 365 days. Standard, but guard against complacency.
Missouri: 12 months. Allows for comprehensive claims management.
Montana: 365 days. Routine checks can prevent surprises.
Nebraska: 6 months. Sufficient for a diligent team.
Nevada: 365 days. Offers a safety net for thoroughness.
New Hampshire: 365 days. Encourages detailed submissions.
New Jersey: 365 days. Standard timeframe, yet requires vigilance.
New Mexico: 90 days. A tight schedule demands promptness.
New York: 90 days. Speed in processing is non-negotiable.
North Carolina to Wyoming
North Carolina: 180 days. Balance speed and accuracy.
North Dakota: 365 days. Provides ample opportunity for corrections.
Ohio: 365 days. Consistency is the goal.
Oklahoma: 12 months. Time to ensure detail accuracy.
Oregon: 12 months. Enough to catch and rectify errors.
Pennsylvania: 180 days. Short, but manageable with effective systems.
Rhode Island: 12 months. Use it to your advantage.
South Carolina: 365 days. Enough time for cautious review.
South Dakota: 6 months. Tight, but feasible with streamlined processes.
Tennessee: 365 days. Encourages thoroughness.
Texas: 95 days. One of the shortest—prioritize this.
Utah: 365 days. Offers room for error correction.
Vermont: 365 days. Rewards proactive management.
Virginia: 12 months. Generous, yet demands diligence.
Washington: 365 days. Ample time for perfection.
West Virginia: 365 days. Encourages strategic planning.
Wisconsin: 365 days. Supports detailed reviews.
Wyoming: 365 days. Allows for meticulous processing.
Tips for Staying Compliant
Set System Alerts: Automate reminders for upcoming deadlines. Let technology do the memory work.
Double-Check Portal Entries: Medicaid portals can be unforgiving (and sometimes glitchy). Ensure entries are correct.
Escalate Quickly: If a claim is denied for timely filing, investigate immediately. Don’t assume it’s correct—sometimes it's a system error.
Audit Regularly: Review submission logs and denial codes. Catch patterns before they cost too much.
Team Training: Keep your billing team updated about any changes to state filing limits. Knowledge gaps can lead to costly mistakes.
The Bottom Line
Knowing each state's Medicaid timely filing deadline isn't just about compliance—it's about keeping the revenue cycle flowing. Missed deadlines mean missed dollars, plain and simple. Equip your team with the right tools and knowledge to never let a claim fall through the cracks. Stay organized, stay informed, and most importantly, stay ahead.
Related Articles
