# Medicaid Timely Filing Limits for NEMT Claims: State and Broker Deadlines

Canonical URL: https://nemtguide.com/glossary/timely-filing-limit/ · Updated 2026-09-28

The Medicaid timely filing limit is the deadline to submit a claim, counted from the date of the ride. Federal rule 42 CFR 447.45 caps it at 12 months, but most payers set less: 90 days in New York, 95 days for Texas fee-for-service rides, and 60 days at some brokers. A claim that misses the limit is usually denied, and the trip goes unpaid.

- Federal rule 42 CFR 447.45 makes states require claims within 12 months of the date of service, and most set a shorter limit.
- Broker contracts are often the shortest: WellTrans in Indiana wants invoices within 60 days of the ride.
- Retroactive eligibility, Medicare billed first, and late authorizations can extend the limit, but only with proof attached.
- Payer records prove you filed on time: remittances, rejection reports, and claim status responses. Your own notes usually do not.
- Bill every week and track each claim against the shortest limit you work under.

## What the timely filing limit is

The timely filing limit is the last day a payer will accept your claim for a ride. Most limits count from the date of service, the day you drove the rider. A claim that arrives after the limit is denied, and unless an exception applies, that trip is never paid.

Federal rule 42 CFR 447.45(d)(1) sets the outer limit: every state Medicaid agency must require providers to submit all claims no later than 12 months from the date of service. States, their health plans, and their [brokers](https://nemtguide.com/glossary/nemt-broker/) can set shorter limits, and most do.

The same rule sets how fast the state must pay once it has a clean claim, one it can process without asking you or anyone else for more information. The agency must pay 90 percent of clean claims from practitioners within 30 days of receipt and 99 percent within 90 days. Under 42 CFR 447.46, a Medicaid health plan's contract must meet the same timelines unless the plan and its providers agree to a different schedule in the contract.

## Filing limits by state

These are fee-for-service limits from each state's own rules. Health plans and brokers in the same state may set their own.

| Program | First claim must arrive within | Rule |
|---|---|---|
| New York | 90 days of the date of service | 18 NYCRR 540.6. Confirm the trip in the broker's system within 30 days first. |
| Texas Medical Transportation Program | 95 days for in-state providers, 365 days for out-of-state providers | September 2026 handbook |
| Indiana | 180 days | 405 IAC 1-1-3, Claim Submission module version 8.5 |
| Illinois | 180 days, or 24 months when Medicare must decide the claim first | Handbook of March 11, 2024. The 180 days also covers corrected claims. |
| North Dakota | 180 days | NEMT manual updated January 2026. The state may waive or extend it in some cases. |
| Arizona AHCCCS | 6 months, and 12 months to reach clean claim status | A.R.S. 36-2904(G), Chapter 4 revised November 3, 2025 |
| Medi-Cal | Six months following the month of service | Claims in months 7 to 9 pay 75 percent, months 10 to 12 pay 50 percent, and later claims deny (Welfare and Institutions Code 14115) |
| Ohio | 365 days | Ohio Administrative Code 5160-1-19, effective February 1, 2023 |
| Louisiana (claims to the broker) | 365 days | Medicaid manual chapter 10, section 10.6, issued July 14, 2025 |

New York's rule has three more deadlines. A claim with errors must be corrected and resubmitted within 60 days of the notice. A claim delayed by circumstances outside your control must go in within 30 days of coming back within your control. Every claim must be finally submitted within 2 years.

## Broker filing limits

When a broker pays you, your provider agreement or the broker's manual sets the limit. It is often shorter than the state's.

| Broker and program | Limit |
|---|---|
| WellTrans, Indiana (agreement revised October 16, 2025) | Invoices within 60 days of the date of service. Invoices more than 90 days after are disallowed in full. |
| MTM Health, standard agreement (January 1, 2023 version posted by Pennsylvania) | Claims more than 90 days after the date of service are not paid, unless MTM's client sets another limit |
| MTM Health, Virginia fee-for-service (handbook approved August 10, 2026) | A clean claim within 6 months of the date of service. A denied claim can be appealed within 365 calendar days. |

For how brokers pay and what they want with each invoice, see [how to bill NEMT brokers](https://nemtguide.com/guides/how-to-bill-nemt-brokers/) and the [MTM Health](https://nemtguide.com/brokers/mtm-health/) and [WellTrans](https://nemtguide.com/brokers/welltrans/) guides.

## When the limit is extended

Most payers give more time for a few reasons you cannot control. Each one needs proof attached to the claim.

| Reason | How the payer extends the limit |
|---|---|
| Medicaid approved after the ride | Indiana: one year from the date eligibility was entered. Arizona: 6 months from the date eligibility was posted. Ohio: 180 days from the eligibility notice or hearing decision. New York: a trip attestation up to 120 days after eligibility appears. |
| Medicare billed first | Federal rule 42 CFR 447.45(d)(4)(ii) lets the state pay within 6 months after notice of Medicare's decision. MTM Health in Virginia and WellTrans start their clocks on the Medicare denial date, and WellTrans wants a copy of the denial. Illinois allows 24 months when Medicare must decide first. |
| Another insurer answered late | Indiana: 180 days from the date on the other payer's explanation of benefits. Ohio: 180 days after another payer reverses its payment and recovers the funds. |
| Authorization approved late | Indiana: 180 days from the date a retroactive prior authorization was approved, with the approval attached. Medi-Cal: enter a delay reason code in box 24C when the authorization process delayed the claim. |
| The payer caused the delay | Indiana waives the limit when a state or contractor error caused it. Ohio may pay after 365 days when its own action delayed the claim. |

New York and Medi-Cal use standard delay reason codes on the claim. New York's guide lists them: 1 for proof of eligibility unknown, 3 for authorization delays, 7 for a third party processing delay, 8 for a delay in eligibility determination, and 10 for an administrative delay in the prior approval process, among others. See [prior authorization for NEMT](https://nemtguide.com/glossary/prior-authorization/).

## How to prove a claim was filed on time

A timely filing denial can often be reversed if you can show the payer had your claim before the limit. The proof has to come from the payer's side.

1. **Save every payer response the day it arrives.** Indiana accepts remittance advice statements, 277 claim status responses, screen prints from its provider portal, answered inquiries, dated explanations of benefits from other payers, and its own records of an earlier submission.
2. **Do not rely on your own notes.** Indiana says provider-generated notes and claim filing timelines are not acceptable proof, and claims without acceptable documentation deny automatically.
3. **Keep rejection letters.** Texas lets a newly enrolled provider whose application is still pending use its claims processor's rejection reports and return-to-provider letters as proof that it met the 365-day deadline.
4. **Resubmit with the original claim number.** Arizona says a replacement claim must carry the original claim reference number. Without it, the claim is treated as new and can deny as past the limit.
5. **Adjust paid claims instead of voiding them.** New York treats a claim sent after a void as a brand-new claim, with every timeliness edit applied again.
6. **Attach one proof set to each claim.** Indiana reviews each late claim on its own and rejects one set of papers for several claims.

Read your [remittance advice](https://nemtguide.com/guides/read-remittance-advice/) each week so a rejection or denial never sits unnoticed, and learn the difference between the two in claim rejection vs denial.

## Corrected claims and the clock

Fixing a claim does not always give you new time. Indiana treats a denied claim resubmitted with corrections as a new first claim, still subject to 180 days from the date of service. Arizona gives you until 12 months from the date of service to reach clean claim status, if the first claim arrived within 6 months. Illinois requires corrected claims inside the same 180 days.

For the steps, see corrected NEMT claims and [how to appeal a denied claim](https://nemtguide.com/guides/appeal-denied-nemt-claim/).

## One ride, many deadlines

Here is the last filing day for a ride on March 3, 2026 under each limit, counting the day after the ride as day 1. Ask your payer how it counts, and file well before the last day.

| Limit | Last day for a March 3, 2026 ride |
|---|---|
| 60 days (WellTrans) | May 2, 2026 |
| 90 days (New York, MTM standard agreement) | June 1, 2026 |
| 95 days (Texas fee-for-service, in-state) | June 6, 2026 |
| 180 days (Indiana, Illinois, North Dakota) | August 30, 2026 |
| 6 months (Arizona, MTM Health in Virginia) | September 3, 2026 |
| Six months following the month of service (Medi-Cal full pay) | September 30, 2026 |
| 365 days (Ohio, Louisiana broker claims) | March 3, 2027 |
| 12 months (federal outer limit) | March 3, 2027 |

The timely filing calculator works out the date for any ride and limit.

## A billing routine that stays inside every limit

1. **Know your shortest limit.** List every payer you drive for and its limit, and plan around the shortest one.
2. **Bill every week.** A weekly batch keeps even a 60-day limit comfortable.
3. **Check eligibility before the ride.** A claim that comes back for an eligibility problem after the limit has passed may not be fixable.
4. **Work rejections within days.** Every day a rejected claim sits is a day off its limit.
5. **Track open claims by age.** Your [accounts receivable](https://nemtguide.com/guides/nemt-accounts-receivable/) report should show each claim's date of service and its last filing day.
6. **Keep proof for years.** North Dakota requires records for 7 years, and a timely filing dispute can come up long after the ride.

For the full claim process, see [how to bill Medicaid for NEMT](https://nemtguide.com/guides/how-to-bill-medicaid-for-nemt/) and [NEMT claim denials](https://nemtguide.com/guides/nemt-claim-denials/).

## Frequently asked questions

### What is the federal timely filing limit for Medicaid claims?

Twelve months from the date of service. Federal rule 42 CFR 447.45(d)(1) requires every state Medicaid agency to have providers submit all claims no later than 12 months after the service. States, health plans, and brokers may set shorter limits, and most do, from 60 days at some brokers to 365 days in Ohio.

### Does the timely filing clock start on the date of the ride?

Usually yes. Most limits count from the date of service, the day the rider was driven. Medi-Cal counts six months following the month of service instead, and some limits restart on a later event: the date retroactive eligibility was posted, the date Medicare denied the claim, or the date on a denial notice for a corrected claim.

### What if the rider's Medicaid is approved after the ride?

Most programs give you more time, counted from when eligibility is posted. Indiana allows one year from the date eligibility was entered in its system. Arizona allows 6 months from the date eligibility is posted. Ohio allows 180 days from the eligibility notice. New York allows a trip attestation up to 120 days after eligibility appears. Attach proof of the retroactive date to the claim.

### How do I prove I filed a claim on time?

Keep the payer's own records of your first submission: remittance advice, claim status responses, rejection reports, and portal screen prints. Indiana lists these as acceptable proof and says provider-generated notes and timelines are not. Texas lets newly enrolled providers use its claims processor's rejection reports or return-to-provider letters as proof of meeting its 365-day deadline.

### Is a broker's filing deadline the same as the state's?

Not always. A broker's deadline comes from your provider agreement and can be shorter than the state's. WellTrans in Indiana wants invoices within 60 days of the ride, while Indiana fee-for-service allows 180. MTM Health's Virginia handbook allows 6 months. Louisiana's Medicaid manual sets 365 days for claims sent to its broker. Read the payment section of every contract you sign.

## Official resources

- [eCFR: 42 CFR 447.45, Timely claims payment](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-447/subpart-A/section-447.45)
- [New York: Guide to Timely Billing and delay reason codes](https://www.emedny.org/ProviderManuals/AllProviders/Guide_to_Timely_Billing.pdf)
- [Indiana Health Coverage Programs: Claim Submission and Processing module (filing limits, section 11)](https://www.in.gov/medicaid/providers/files/modules/claim-submission-and-processing.pdf)
- [AHCCCS: Chapter 4, General Billing Rules](https://www.azahcccs.gov/PlansProviders/Downloads/FFSProviderManual/FFS_Chap04GeneralBillingRules.pdf)
- [Medi-Cal: Claim Submission and Timeliness Overview](https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=claimsub.pdf)
- [TMHP: Medical Transportation Program Handbook (September 2026)](https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2026/2026-09-september/2_14_med_transport_program.pdf)