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3rd – 5th Levels of Appeal

Providers, suppliers and beneficiaries (or their respective appointed representatives) have the right to appeal a Medicare coverage and payment decision. There are five levels in the Medicare appeals process. A provider, supplier or beneficiary 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 $180 for requests filed in calendar years 2023 and 2024
Fourth Level of Appeal: Department Appeals Board (DAB) Review/Appeals CouncilExternal Website Within 60 days of receipt of the ALJ hearing decision None
Fifth Level of Appeal: Federal Court ReviewExternal Website Within 60 days receipt of the Appeals Council decision $1,850 for requests filed on or before December 31, 2023
$1,840 for requests filed on or after January 1, 2024

Updated: 10.12.23


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