Medicaid for billing teams
Payer ID, timely filing, appeals and prior authorization for state medicaid programs, from Medicaid's own documents, checked in October 2026.
What you get
- Payer IDs, filing limits and appeal deadlines
- A link to the payer's own document for each one
- An email when a payer changes a rule
Medicaid
State Medicaid programs · checked in October 2026
- Payer ID for claims
- Set by each state. Check your state Medicaid agency or your clearinghouse.
- Timely filing limit
- No later than 12 months from the date of service, under federal rules. Your state sets the details.42 CFR 447.45
- Appeal deadline
- Set by each state. Federal rules set no single deadline for provider claim appeals.
- Prior authorization
- Varies by state. Since January 1, 2026, decisions are due within 7 calendar days, or 72 hours when urgent. Drugs are excluded.42 CFR 440.230
- Eligibility checks
- 270/271 checks, required for Medicaid under HIPAA, through your state's system or a clearinghouse.45 CFR 162.1202
- Provider portal
- Set by each state.
- Provider phone
- Set by each state.
Medicaid does not allow practices to bill patients for missed appointments.