Timely filing calculator: the last day to bill each NEMT trip

How to use the timely filing calculator

Enter the date the payer’s clock starts, the payer’s limit, and the day you plan to submit. The calculator returns the last day to file, the Friday to file by when that day is a weekend, and the days left. For what a filing limit is and the exceptions payers allow, read the timely filing limit page.

1. Pick the date the clock starts. For a first claim that is the date of service. For a corrected claim it is usually the date on the payer’s notice.
2. Choose count the limit from: “That date” for most payers, or “The end of that month” for a payer that counts months from the end of the month of the ride.
3. Enter the limit the way the manual words it. “6 months” goes in the months box and “95 days” in the days box.
4. Pick the day you plan to submit, or use today’s date.
5. Read the last day, the days left, and the day to file by.

Which date starts the clock

For a first claim it is the date of service, and for anything else it is the date your payer’s rules name. These four starting points come up in the manuals below:

• The date of service. Most of the limits in the table further down count from the ride itself. Enter the ride date and the payer’s days or months.
• The end of the month of service. South Dakota Medicaid must receive a claim within 6 months following the month the services were provided, and its table lists the last month to submit: a January ride must arrive by the end of July. Choose “The end of that month” and enter 6 months.
• The date on the payer’s notice. New York’s Guide to Timely Billing gives 60 days from the date of notification to send a corrected claim, and defines that date as the date of the remittance. Enter the remittance date and 60 days.
• A primary payer’s denial. MTM Health’s Virginia handbook starts the 6 months at Medicare’s denial for trips billed to Medicare first. WellTrans’s agreement starts its clock on the date Medicare or another primary payer denies the claim. Enter the denial date.

The day you submit means the day the payer has the claim. Texas Medicaid denies claims it receives more than 95 days after the ride, and South Dakota Medicaid must receive the claim within its 6 months, so a claim sent on the last day can arrive late.

How the calculator counts months and days

Months are added first and keep the day of the month. Days are then counted forward from that date, and the day after it is day 1. A ride on September 14 with a 90-day limit therefore ends on December 13. When the target month is too short, the count ends on its last day: a ride on August 31 with a 6 month limit ends on February 28.

A rule worded “within 95 days of the date of service” does not say whether the date of service counts as day 1. If your payer’s wording is unclear, assume the stricter reading, which makes your deadline one day earlier, or ask the payer in writing.

Worked example

The default inputs are examples. A trip was driven on Monday, September 14, 2026. The payer allows 90 days, and its manual says nothing about weekends. You are checking on October 6, 2026.

Change two numbers to see a weekday deadline. A ride on August 14, 2026 with a 180-day limit has a last day of Wednesday, February 10, 2027, with no weekend to back up from, and 127 days left on October 6.

The same ride under five rules

A ride on Friday, August 14, 2026 has five different last days depending on whose rule you are under. The table shows what to enter for each. The timely filing limit page lists more payers’ limits and the exceptions they allow.

Three of the five last days land on a weekend. The federal ceiling in 42 CFR 447.45(d)(1) is 12 months from the date of service, and it is a cap on what a state may allow, not the limit your payer uses. The limit that binds you is the one in the manual or agreement of whoever you bill.

When the last day falls on a weekend

Check the payer’s manual first, and if it says nothing, file by the Friday before. Payers differ. Texas Medicaid’s claims filing chapter (September 2026) extends a 95-day claims deadline or a 120-day appeal deadline that falls on a weekend or a holiday to the next business day, and lists the holidays that count in 2026. The Medical Transportation Program handbook states the 95 days without repeating that sentence, so confirm with TMHP that it applies to ride claims. Medicare does the same in its own rule: a last day that falls on a Saturday, Sunday, or legal holiday moves to the next workday (42 CFR 424.44(c)). The Medicaid filing rule in 42 CFR 447.45(d)(1) has no such sentence, and neither do the Indiana, South Dakota, New York, MTM Health, and WellTrans documents cited on this page. WellTrans’s agreement pays on the next working weekday when a payment date lands on a holiday, but that is the payment clock, not the filing clock.

The calculator shows the last day as counted and, below it, the Friday to file by. Where your payer does move a weekend deadline, the real last day is the Monday after. The calculator knows weekends only, so add a day or two of margin around holidays your payer observes.

When one agreement gives two numbers

Plan around the shorter number and ask the payer in writing which one governs. In its payment terms, WellTrans’s provider agreement (revised October 16, 2025) makes a 60-day deadline a condition of payment and disallows invoices submitted after 90 days. Section 4.3 of the same document says 90 days. Run the calculator twice. For a ride on August 14, 2026, 60 days ends October 13 and 90 days ends November 12.

Having the trip record ready

The clock starts the day the trip is driven, so the documents behind each bill are best finished that day. In HealthRide, each finished trip lands in a trip log with its planned and actual times, the driver, the vehicle, and GPS-verified miles, and the log downloads as a spreadsheet or a PDF to print. See reports. For the work that follows a denial, see corrected claims and appealing a denied claim.