MassHealth Timely Filing Limit

Coverage: Massachusetts MassHealth fee-for-service billing; managed care organizations and ACO arrangements can have different routing and rules.

MassHealth filing guidance from the reviewed sources: Initial fee-for-service claims: 90 days from service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• MassHealth has separate initial, final and coordination-of-benefits filing windows.

Initial claim filing limits

• Initial fee-for-service claims: 90 days from service.
• COB initial claims: 90 days from the primary insurer’s EOB.

Corrected claim filing limits

• Final filing: 12 months from service if initial filing met the 90-day service-date limit.
• COB final filing: 18 months from service if initial filing met the 90-day primary-EOB limit.

Appeal and reconsideration deadlines

• Not clearly published in the researched sources.

Trigger basis and caveats

• These conditional final limits do not excuse late initial filing. Apply the relevant exception/appeal procedure where needed. Do not confuse Medicare crossover processing time with a filing deadline.

Provider resources

• Official policy source (official)
• Official policy source (official)
• Official policy source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Verified official billing timelines, billing resources and 2026 PA changes. Preserved conditional final-filing limits and the drug exclusion.
• No universal MCO deadline or routing is inferred from MassHealth fee-for-service rules. Member eligibility, provider enrollment and portal access still require checks.