New York Timely Filing for Therapists: Essential Guide

New York timely filing for therapists means getting each claim to the right payer before that payer’s deadline runs out. The deadline depends on who pays: New York Medicaid, a commercial plan, or Medicare. Check the payer’s own manual first, because the number on your contract can be shorter than the one in state law.

What is the claim filing deadline for New York therapists?

There is no single deadline. Each payer sets its own, and the Timely Filing clock usually starts on the Date of Service. In this post: New York Medicaid is 90 days to submit and two years to be payable, the state commercial rule starts at 120 days, and Medicare allows one calendar year.

Psychotherapists and psychiatrists follow the same clocks. The difference is volume: prescribers who bill an evaluation and management visit plus a psychotherapy add-on have more lines per claim that can reject. See psychiatry billing services for how those claims are built.

New York timely filing for therapists: Medicaid rules

New York Medicaid timely filing is set in the eMedNY (the state’s Medicaid billing system) manual called Information for All Providers: General Billing. This section covers fee-for-service rules from Version 2025-1, dated June 9, 2025. Managed care plans can set their own rules, so check each plan’s manual.

• Initial submission: the manual says claims should be submitted within 90 days of the date of service.
• Payable limit: claims must be payable within two years of the date the service was furnished.
• Older than 90 days: the claim needs a numeric delay reason code. Paper claims also need a separate eMedNY delay reason code form for each claim.
• Corrected or adjusted claims: resubmit within 60 days of the notice of rejection, denial or payment correction.
• Past two years: the manual says such claims are considered only when the delay came from Department or agency error, or when a court ordered payment.

Read the delay reason code section before you use a code. Some codes carry their own deadlines, and the manual lists at least one that causes an electronic claim to deny. Source: eMedNY General Billing manual, checked October 29, 2026.

Medicaid managed care plans

Aetna Better Health of New York, a Medicaid managed care plan, says in its provider manual that claims must be filed within 120 days of the date of service unless a contract exception applies. Its page was last modified June 29, 2026. Another plan may differ, so open the manual for each Medicaid plan you bill. Source: Aetna Better Health of New York provider manual, claims.

New York timely filing for therapists: commercial plans

New York commercial timely filing is a mix of state law and your payer contract. New York Insurance Law section 3224-a covers prompt payment: insurers must pay within 30 days of an electronic claim or 45 days for other claims. It also sets a default for providers, with room for contracts that are more favorable to you.

• Provider submission: providers generally must first submit a claim within 120 days of the date of service, and parties may agree to terms more favorable to the provider.
• Reconsideration: if a claim is denied only for being late, you can ask the insurer to reconsider. The law says the insurer must pay if you show an unusual occurrence caused the delay and that you have a pattern of timely filing.
• Reduced payment: the insurer may cut payment on a late claim by up to 25 percent of what it would otherwise have paid.
• Full denial: for claims submitted 365 days or more after the date of service, the insurer may deny in full.

Source: New York Insurance Law section 3224-a, checked October 29, 2026. This is a summary for billing operations, not legal advice. Ask your attorney whether the statute applies to a specific plan, such as a self-funded employer plan. For how commercial claims move in New York, read New York commercial mental health billing.

New York timely filing for therapists: Medicare rule

Medicare timely filing is one calendar year. The Medicare Claims Processing Manual, Chapter 1, says a claim is untimely when received more than 12 months or one calendar year after the date services were furnished. For most claims the clock starts on the “from” date of service.

The manual lists exceptions, including administrative error by Medicare or a contractor and retroactive Medicare entitlement. Do not plan around them. Source: CMS Transmittal 12909, dated October 24, 2024, checked October 29, 2026. Your Medicare Administrative Contractor publishes the same rule on its own site.

How do I protect a late claim in New York?

You protect a claim by proving, with dated records, that you sent it on time. Keep a Clearinghouse acceptance report for every batch. A rejection from the clearinghouse before the payer ever sees the claim is not a submission, so fix it the same day.

1. Save the acceptance report. It shows the file reached the payer on a date. Our guide to proof of timely filing for behavioral health lists what to keep.
2. Work rejections and denials fast. In New York Medicaid fee-for-service, a corrected claim has its own 60-day window.
3. Choose the right fix. A data error needs a corrected claim. A wrong decision needs an appeal. Corrected claim or appeal walks through the choice.
4. Ask for reconsideration in writing. Include your proof of timely filing and the payer’s claim number.
5. Check the other payer first. If another plan is primary, read the secondary payer’s manual to see when its clock starts.

Weekly habits that keep claims inside the deadline

A weekly claim review is the simplest defense. For New York timely filing for therapists, pull every claim with no payment or response after the date it should have been paid. Do it every Monday, not at month end.

• Submit claims within days of the session, not at the end of the month.
• Track unpaid claims by days since the date of service, and flag any past 60.
• Read each payer’s manual once a year, since limits change. Compare how other states set theirs, for example Georgia and Texas.
• Compare the general rule in timely filing for therapists with your New York payers.

The state-level picture lives in the New York billing guide, and solo practices can start with solo therapist billing in New York.

How MCM South helps with New York timely filing for therapists

MCM South bills for psychotherapists and psychiatrists, including out-of-network claims for clients. We help with the billing side of timely filing, such as tracking claim status and working denials. We do not give legal advice, so questions about a statute go to your attorney.

Where MCM South works

MCM South works with psychotherapists and psychiatrists in ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. See insurance company contacts by state, who we serve and the state billing guides. This post is operational guidance for billing, not legal advice.

The short version: new york timely filing for therapists

New York timely filing for therapists depends on the payer: 90 days to submit for Medicaid fee-for-service, 120 days as the state’s default for commercial plans, and one calendar year for Medicare. Keep acceptance reports, work rejections the day they arrive, and read each payer’s manual. More guides are in Resources.

Sources checked (October 29, 2026)

• eMedNY Information for All Providers: General Billing, Version 2025-1 (June 9, 2025)
• New York Insurance Law section 3224-a (NY Senate)
• CMS Medicare Claims Processing Manual Ch.1 Transmittal 12909 (10/24/2024)
• Aetna Better Health of New York provider manual, claims (Medicaid managed care)

Frequently asked questions