# Original Medicare timely filing limit for dental claims

> What is the timely filing limit for dental claims with Original Medicare, and how long do you have to correct or appeal? Verdict: Published filing window.

URL: https://dentovio.com/dental-timely-filing-limits/medicare

Payer of record: Original Medicare (fee-for-service)

Last verified: 2026-08-30

Dentovio is an independent publisher — not a payer, the American Dental Association, or any government agency, and it is unaffiliated with the insurers named here. This page was drafted with AI assistance and verified against the primary sources linked here. It has not been reviewed by a credentialed dental billing specialist or attorney. These pages record filing, correction, appeal, records, and recoupment windows as read in each payer's published documents on the last-verified date — and record honestly where no public number exists. Provider contracts override published manuals, editions change, and several payers set different rules per state, network, or program. Educational reference only, not billing or legal advice; confirm the controlling number in your participation contract and the payer's current provider manual before relying on it.

## Direct answer

The initial dental filing window for Original Medicare (fee-for-service) is 12 months — “the claim must be filed no later than the close of the period ending 1 calendar year after the date of service” (42 CFR § 424.44(a)(1)) — with narrow exceptions in (b) (administrative error, retroactive Medicare entitlement, Medicaid recoupment, retroactive MA/PACE disenrollment) and a non-workday rollover in (c). Provider contracts and plan documents override published manuals — the contract number controls. Last verified 2026-08-30.

## Filing windows

- **Initial claims:** 12 months — “the claim must be filed no later than the close of the period ending 1 calendar year after the date of service” (42 CFR § 424.44(a)(1)) — with narrow exceptions in (b) (administrative error, retroactive Medicare entitlement, Medicaid recoupment, retroactive MA/PACE disenrollment) and a non-workday rollover in (c) (Published openly)

## Appeals

No appeal level was extracted for this payer this pass — that is an extraction gap, not a statement that no appeal process exists.

## Verified caveats

- A rejected or returned-as-unprocessable claim is not considered filed for timely-filing purposes (CMS Pub. 100-04, Ch. 1, §70.2.3); a denied claim is filed and preserves the filing date. Returned-claim records are typically purged within 60 days with no audit trail — correct and resubmit fast.
- Crossover: when the Medicare claim was filed timely, the state Medicaid agency may pay the related Medicaid claim within 6 months after notice of the Medicare disposition (42 CFR § 447.45(d)(4)(ii)).
- § 424.44 is a Medicare rule only — it imposes nothing on Medicaid agencies. The Medicaid filing rule is 42 CFR § 447.45(d)(1); see the Medicaid record on this hub.
- Medicare Advantage dental was not verified this pass — each MA plan's provider materials govern its windows.

## Sources

- [42 CFR § 424.44 — Time limits for filing claims (eCFR)](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-424/subpart-C/section-424.44) — §424.44(a)(1), (b), (c)

## Related

- [All payer timely-filing pages](https://dentovio.com/dental-timely-filing-limits/index.html.md)
- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Dental prompt-pay laws by state](https://dentovio.com/dental-prompt-pay-laws/index.html.md)