Administrative Law Judge (ALJ)

If the appellant is dissatisfied with the Reconsideration decision and the amount remaining in controversy meets the threshold (may be an aggregate of multiple claims), the appellant is entitled to a hearing (which includes in-person, teleconference, or video-teleconference appearances) before an ALJ with the Office of Medicare Hearings and Appeals (OMHA), or an on-the-record review by an OMHA adjudicator.

Time Limit for Filing Request Monetary Threshold to be Met Time Limit to Complete Appellant's Request Where to File
60 days from Reconsideration receipt date $190 for 2025 90 days from receipt date HHS OMHA Centralized Docketing

 

View more information on the CMS Third Level of Appeal: Decision by Office of Medicare Hearings and Appeals (OMHA) webpage.

Resource

 

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