Medicare AdvantageAdministrativeMedium impact
25-300 Submission Timelines Extended from 60 to 65 Days for Certain Appeals
Health Net·CA·Reimbursement
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
CMS has extended the timeframe for submitting appeals from 60 to 65 calendar days, effective January 1, 2025. Participating Physician Groups (PPGs) must immediately start using updated notification and denial letter templates that reflect the new 65-day timeline.
Action Required
Immediately: PPGs must download and begin using updated notification and denial letter templates from the HICE website (iceforhealth.org). Replace all current templates including Notice of Denial of Medical Coverage (NDMCP), AIP Coverage Decision Letter, Notice of Medicare Non-Coverage (NOMNC), and Waiver of Liability (WOL) to reflect the new 65-day appeal timeline. Update any automated systems or processes that generate these letters.