3rd – 5th Levels of Appeal
There are 5 levels in the Medicare appeals process. Any party (provider, supplier, beneficiary, or appointed representative) that is dissatisfied with an appeal decision at the prior level may file a request to the next level of appeal.
- Original Medicare (Fee-for-service) Appeals | CMS

- Medicare Claims Processing Manual (Pub. 100-04), Chapter 29 – Appeals of Claims Decisions | CMS

| Level of Appeal | Time Limit to File a Request | Minimum Dollar Amount in Controversy |
|---|---|---|
| Third Level of Appeal: Administrative Law Judge | CMS |
Within 60 days of receipt of the reconsideration decision or dismissal | $200 for requests filed on or before December 31, 2026 $200 for requests filed on or after January 1, 2027 |
| Fourth Level of Appeal: Medicare Appeals Council | CMS |
Within 60 days of receipt of the ALJ hearing decision or dismissal | None |
| Fifth Level of Appeal: Federal District Court | CMS |
Within 60 days of receipt of the Medicare Appeals Council decision | $1,960 for requests filed on or before December 31, 2026 $2,000 for requests filed on or after January 1, 2027 |
Updated: 10.06.2026

