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October 20, 2020

Updated 2021 Amount in Controversy (AIC) for Administrative Law Judge Hearings or Federal District Court Appeals

The Centers for Medicare & Medicaid Services (CMS) has notified Medicare contractors of the update to the Amount in Controversy (AIC) required to sustain Administrative Law Judge (ALJ) or Federal District Court appeal rights beginning January 1, 2021.

  • The amount remaining in controversy requirement for ALJ hearing requests made on or before December 31, 2020, is $170.  This amount will increase at $180 for ALJ hearing requests filed on or after January 1, 2021.
  • The amount that must remain in controversy for reviews in Federal District Court requested on or before December 31, 2020 is $1,670. This amount will increase to $1,760 for appeals to Federal District Court filed on or after January 1, 2021.

Please share this with your appropriate staff.

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