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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.

Level of Appeal Time Limit to File a Request Minimum Dollar Amount in Controversy
Third Level of Appeal: Administrative Law JudgeExternal Website Within 60 days of receipt of the reconsideration decision or dismissal $190 for requests filed on or before December 31, 2025
$200 for requests filed on or after January 1, 2026
Fourth Level of Appeal: Department Appeals Board (DAB) Review/Appeals CouncilExternal Website Within 60 days of receipt of the ALJ hearing decision or dismissal None
Fifth Level of Appeal: Federal Court ReviewExternal Website Within 60 days of receipt of the Appeals Council decision $1,900 for requests filed on or before December 31, 2025
$1,960 for requests filed on or after January 1, 2026

Updated: 12.16.2025

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