Timely filing limit
Updated September 30, 2026
Definition
The deadline for a provider to send a claim to your health plan. For Original Medicare, it's 12 months after the date of service. Other plans set their own limits.
A timely filing limit is the deadline for a provider to send a claim to your health plan. For Original Medicare, claims must be filed within 12 months of the date of service. Other plans set their own deadlines, so check with yours.
If a claim arrives too late, the plan can deny it. Your explanation of benefits (EOB) may show reason code 29, which means the time limit for filing has expired.
A late claim is often the provider's responsibility, not yours. Under Medicare rules, a provider that files late can't charge you for the service. It can bill only the deductible and coinsurance you'd have owed if Medicare had paid. For example, say a $600 lab claim is denied for late filing, and your coinsurance would have been $60. The most the provider can bill you is $60. With other plans, the provider's contract may set similar limits, so ask the billing office before you pay.
Related terms
Guides that use this term
- GuideHow long can a hospital wait to bill you?Got a hospital bill months after your care? See which time limits apply, what happens when a claim is filed late, and what to check before you pay it.
- GuideInsurance didn't pay my medical bill: what to do nextInsurance didn't pay your medical bill? Find out why, match the denial code to the fix, and learn when to ask for a rebill and when to file an appeal.
Sources
- Filing a claim, Medicare.gov. Accessed September 30, 2026.
- Claims denial for late filing, Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
- Claim adjustment reason codes, X12. Accessed September 30, 2026.
This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.