Summaries of Key Payer Reimbursement Time Frames and Penalties

The following information provides summaries of potential time frames that payers must follow for reimbursing services rendered by health care providers within the 50 states, US territories, ERISA, and Medicare Advantage. It also delineates potential penalties in place if payers miss these time frames within each jurisdiction.¹ This is provided for informational purposes only, is subject to change, and should not be construed as legal advice.

Sort for your state:

Alabama

Days to Pay: 30
Penalty: 1.5% per month
Authority: Alabama Insurance Code Section 27-1-17

Alaska

Days to Pay: 30
Penalty: 15% per year
Authority: Alaska Statutes Section 21.36.495

Arizona

Days to Pay: 30
Penalty: Legal rate*
Authority: Arizona Revised Statutes Section 20-3102

Arkansas

Days to Pay: 30
Penalty: 12% per year
Authority: Arkansas Department of Insurance Rule 43 § 12

California

Days to Pay: 30 working days
Penalty: 15% per year
Authority: California Health and Safety Code Section 1371.35

Colorado

Days to Pay: 30
Penalty: 10%-20% per year
Authority: Colorado Revised Statute Section 10-16-106.5

Connecticut

Days to Pay: 20
Penalty: 15% per year
Authority: Connecticut Insurance Code Section 38a-816

Delaware

Days to Pay: 30
Penalty: N/A
Authority: Delaware Administrative Code Rule 1310, Section 6.0

District of Columbia

Days to Pay: 30
Penalty: 1.5%–2.5% per month
Authority: Code of District of Columbia Section 31-3132

Florida

Days to Pay: 20
Penalty: 12% per year
Authority: Florida Insurance Codes Section 627.42392

Georgia

Days to Pay: 15 working days
Penalty: 12% per year
Authority: Georgia Insurance Code Section 33-24-59.5

Guam

Days to Pay: 45
Penalty: 12% per year
Authority: Title 10 Guam Statutes Section 9902

Hawaii

Days to Pay: 15
Penalty: 15% per year
Authority: Hawaii Revised Statutes Section 431:13-108

Idaho

Days to Pay: 30
Penalty: N/A
Authority: Idaho Statutes Section 41-5602

Illinois

Days to Pay: 30
Penalty: 9% per year
Authority: Illinois Insurance Code Section 5/368a

Indiana

Days to Pay: 30
Penalty: TBD
Authority: Indiana Insurance Code Section 27-8-5.7

Iowa

Days to Pay: 30
Penalty: 10% per year
Authority: Iowa Administrative Code Rule 191-15.32 (2)

Kansas

Days to Pay: 30
Penalty: 1% per month
Authority: Kansas Statutes Chapter 40, Section 2442

Kentucky

Days to Pay: 30
Penalty: 12%–21% per year
Authority: Kentucky Insurance Code Section 304.17A-702

Louisiana

Days to Pay: 25
Penalty: 1% per month
Authority: Louisiana Department of Insurance Regulation 74

Maine

Days to Pay: 30
Penalty: 1.5% per month
Authority: Maine Insurance Code Section 2436

Maryland

Days to Pay: 30
Penalty: 1.5%–2.5% per month
Authority: Maryland Insurance Code Section 15-1005

Massachusetts

Days to Pay: 45
Penalty: 1.5% per month
Authority: Massachusetts Insurance Code Chapter 176I Section 2

Michigan

Days to Pay: 45
Penalty: 12% per year
Authority: Michigan Insurance Code Section 500.2006

Minnesota

Days to Pay: 30
Penalty: 1.5% per month
Authority: Minnesota Insurance Code Section 62Q.75

Mississippi

Days to Pay: 25
Penalty: 1.5% per month
Authority: Mississippi Insurance Code Section 83-9-5

Missouri

Days to Pay: 30 processing days
Penalty: 1%–2% per month^†
Authority: Missouri Insurance Code Section 376.383

Montana

Days to Pay: 30
Penalty: 10% per year
Authority: Montana Code Annotated Section 33-18-232

Nebraska

Days to Pay: 30
Penalty: 12% per year
Authority: Nebraska Revised Statute Section 44-8004

Nevada

Days to Pay: 30
Penalty: Prime +6%
Authority: Nevada Revised Statutes Title 57 Section 689B.255

New Hampshire

Days to Pay: 30
Penalty: 1.5% per month
Authority: New Hampshire Insurance Code Section 420-J: 8-a

New Jersey

Days to Pay: 30
Penalty: 12% per year
Authority: New Jersey Administrative Code Rule 11:22-1.5 (a)

New Mexico

Days to Pay: 30
Penalty: 1.5% per month
Authority: New Mexico Statutes Section 59A-16-21.1

New York

Days to Pay: 30
Penalty: 12% per year
Authority: New York Insurance Code Section 3224a

North Carolina

Days to Pay: 30
Penalty: 18% per year
Authority: North Carolina Insurance Code Section 58-3-225

North Dakota

Days to Pay: 15 working days
Penalty: N/A
Authority: North Dakota Code Section 26.1-36-37.1

Ohio

Days to Pay: 30
Penalty: 18% per year
Authority: Ohio Revised Code Section 3901.381

Oklahoma

Days to Pay: 45
Penalty: 10% per year
Authority: Oklahoma Statutes Title 36 Section 1219

Oregon

Days to Pay: 30
Penalty: 12% per year
Authority: Oregon Revised Statutes Section 743B.450

Pennsylvania

Days to Pay: 45
Penalty: 10% per year
Authority: Pennsylvania Insurance Code Section 991.2166

Puerto Rico

Days to Pay: 30
Penalty: TBD
Authority: Laws of Puerto Rico Title 26, Section 3002

Rhode Island

Days to Pay: 30
Penalty: 12% per year
Authority: Rhode Island Insurance Code Section 27-18-61

South Carolina

Days to Pay: 20 working days
Penalty: N/A
Authority: South Carolina Insurance Code Section 38-59-230

South Dakota

Days to Pay: 30
Penalty: N/A
Authority: South Dakota Codified Laws Section 58-12-20

Tennessee

Days to Pay: 21
Penalty: 1% per month
Authority: Tennessee Insurance Code Section 56-7-109 (b)

Texas

Days to Pay: 30
Penalty: 18% per year
Authority: Texas Insurance Code Section 1301.103

Utah

Days to Pay: 30
Penalty: 0.033% per day
Authority: Utah Insurance Code Section 31A-26-301.6

Vermont

Days to Pay: 30
Penalty: 12% per year
Authority: Vermont Insurance Code Section 9418

Virginia

Days to Pay: 40
Penalty: Legal rate*
Authority: Code of Virginia Section 38.2-3407.15

Washington

Days to Pay: 30^‡
Penalty: 1% per month
Authority: Washington Administrative Code Rule 284-170-431

West Virginia

Days to Pay: 30
Penalty: 10% per year
Authority: West Virginia Insurance Code Section 33-45-2

Wisconsin

Days to Pay: 30
Penalty: 7.5% per year
Authority: Wisconsin Insurance Code Section 628.46

Wyoming

Days to Pay: 45
Penalty: 10% per year
Authority: Wyoming Statute Section 26-15-124

Alabama

Days to Pay: 30
Penalty: 1.5% per month
Authority: Alabama Insurance Code Section 27-1-17

Alaska

Days to Pay: 30
Penalty: 15% per year
Authority: Alaska Statutes Section 21.36.495

Arizona

Days to Pay: 30
Penalty: Legal rate*
Authority: Arizona Revised Statutes Section 20-3102

Arkansas

Days to Pay: 30
Penalty: 12% per year
Authority: Arkansas Department of Insurance Rule 43 § 12

California

Days to Pay: 30 working days
Penalty: 15% per year
Authority: California Health and Safety Code Section 1371.35

Colorado

Days to Pay: 30
Penalty: 10%–20% per year
Authority: Colorado Revised Statute Section 10-16-106.5

Connecticut

Days to Pay: 20
Penalty: 15% per year
Authority: Connecticut Insurance Code Section 38a-816

Delaware

Days to Pay: 30
Penalty: N/A
Authority: Delaware Administrative Code Rule 1310, Section 6.0

District of Columbia

Days to Pay: 30
Penalty: 1.5%–2.5% per month
Authority: Code of District of Columbia Section 31-3132

Florida

Days to Pay: 20
Penalty: 12% per year
Authority: Florida Insurance Codes Section 627.42392

Georgia

Days to Pay: 15 working days
Penalty: 12% per year
Authority: Georgia Insurance Code Section 33-24-59.5

Guam

Days to Pay: 45
Penalty: 12% per year
Authority: Title 10 Guam Statutes Section 9902

Hawaii

Days to Pay: 15
Penalty: 15% per year
Authority: Hawaii Revised Statutes Section 431:13-108

Idaho

Days to Pay: 30
Penalty: N/A
Authority: Idaho Statutes Section 41-5602

Illinois

Days to Pay: 30
Penalty: 9% per year
Authority: Illinois Insurance Code Section 5/368a

Indiana

Days to Pay: 30
Penalty: TBD
Authority: Indiana Insurance Code Section 27-8-5.7

Iowa

Days to Pay: 30
Penalty: 10% per year
Authority: Iowa Administrative Code Rule 191-15.32 (2)

Kansas

Days to Pay: 30
Penalty: 1% per month
Authority: Kansas Statutes Chapter 40, Section 2442

Kentucky

Days to Pay: 30
Penalty: 12%–21% per year
Authority: Kentucky Insurance Code Section 304.17A-702

Louisiana

Days to Pay: 25
Penalty: 1% per month
Authority: Louisiana Department of Insurance Regulation 74

Maine

Days to Pay: 30
Penalty: 1.5% per month
Authority: Maine Insurance Code Section 2436

Maryland

Days to Pay: 30
Penalty: 1.5%–2.5% per month
Authority: Maryland Insurance Code Section 15-1005

Massachusetts

Days to Pay: 45
Penalty: 1.5% per month
Authority: Massachusetts Insurance Code Chapter 176I Section 2

Michigan

Days to Pay: 45
Penalty: 12% per year
Authority: Michigan Insurance Code Section 500.2006

Minnesota

Days to Pay: 30
Penalty: 1.5% per month
Authority: Minnesota Insurance Code Section 62Q.75

Mississippi

Days to Pay: 25
Penalty: 1.5% per month
Authority: Mississippi Insurance Code Section 83-9-5

Missouri

Days to Pay: 30 processing days
Penalty: 1%–2% per month^†
Authority: Missouri Insurance Code Section 376.383

Montana

Days to Pay: 30
Penalty: 10% per year
Authority: Montana Code Annotated Section 33-18-232

Nebraska

Days to Pay: 30
Penalty: 12% per year
Authority: Nebraska Revised Statute Section 44-8004

Nevada

Days to Pay: 30
Penalty: Prime +6%
Authority: Nevada Revised Statutes Title 57 Section 689B.255

New Hampshire

Days to Pay: 30
Penalty: 1.5% per month
Authority: New Hampshire Insurance Code Section 420-J: 8-a

New Jersey

Days to Pay: 30
Penalty: 12% per year
Authority: New Jersey Administrative Code Rule 11:22-1.5 (a)

New Mexico

Days to Pay: 30
Penalty: 1.5% per month
Authority: New Mexico Statutes Section 59A-16-21.1

New York

Days to Pay: 30
Penalty: 12% per year
Authority: New York Insurance Code Section 3224a

North Carolina

Days to Pay: 30
Penalty: 18% per year
Authority: North Carolina Insurance Code Section 58-3-225

North Dakota

Days to Pay: 15 working days
Penalty: N/A
Authority: North Dakota Code Section 26.1-36-37.1

Ohio

Days to Pay: 30
Penalty: 18% per year
Authority: Ohio Revised Code Section 3901.381

Oklahoma

Days to Pay: 45
Penalty: 10% per year
Authority: Oklahoma Statutes Title 36 Section 1219

Oregon

Days to Pay: 30
Penalty: 12% per year
Authority: Oregon Revised Statutes Section 743B.450

Pennsylvania

Days to Pay: 45
Penalty: 10% per year
Authority: Pennsylvania Insurance Code Section 991.2166

Puerto Rico

Days to Pay: 30
Penalty: TBD
Authority: Laws of Puerto Rico Title 26, Section 3002

Rhode Island

Days to Pay: 30
Penalty: 12% per year
Authority: Rhode Island Insurance Code Section 27-18-61

South Carolina

Days to Pay: 20 working days
Penalty: N/A
Authority: South Carolina Insurance Code Section 38-59-230

South Dakota

Days to Pay: 30
Penalty: N/A
Authority: South Dakota Codified Laws Section 58-12-20

Tennessee

Days to Pay: 21
Penalty: 1% per month
Authority: Tennessee Insurance Code Section 56-7-109 (b)

Texas

Days to Pay: 30
Penalty: 18% per year
Authority: Texas Insurance Code Section 1301.103

Utah

Days to Pay: 30
Penalty: 0.033% per day
Authority: Utah Insurance Code Section 31A-26-301.6

Vermont

Days to Pay: 30
Penalty: 12% per year
Authority: Vermont Insurance Code Section 9418

Virginia

Days to Pay: 40
Penalty: Legal rate*
Authority: Code of Virginia Section 38.2-3407.15

Washington

Days to Pay: 30^‡
Penalty: 1% per month
Authority: Washington Administrative Code Rule 284-170-431

West Virginia

Days to Pay: 30
Penalty: 10% per year
Authority: West Virginia Insurance Code Section 33-45-2

Wisconsin

Days to Pay: 30
Penalty: 7.5% per year
Authority: Wisconsin Insurance Code Section 628.46

Wyoming

Days to Pay: 45
Penalty: 10% per year
Authority: Wyoming Statute Section 26-15-124

ERISA

Days to Pay: 30^§
Penalty: N/A
Authority: 29 CFR Section 2560.503-1

Medicare Part C

Days to Pay: 30^∥
Penalty: TBD
Authority: 42 CFR § 422.520

Note: Days to pay assumes electronic submission. Days to pay time frames reflect calendar days unless otherwise noted.

*	The legal rates for incurring penalties can be no more than 10% per year in Arizona (unless a different rate is contracted for and agreed to in writing) and no more than 12% per year in Virginia.^2,3
^†	Missouri claims exceeding $35,000 result in added penalty of 1% per day for maximum 100 days.
^‡	Washington time frame applies to 95% of all clean claims submitted.
^§	ERISA initial time frame is subject to 1-time extension of up to 15 days.
^∥	Medicare Part C time frame applies to 95% of all clean claims submitted.

ERISA = Employee Retirement Income Security Act.

References: 1. Data on file. Regeneron Pharmaceuticals, Inc. 44-1201. 2. Rate of interest for loan or indebtedness; interest on judgments; definitions. Arizona state legislature. Accessed March 10, 2023. https://www.azleg.gov/ars/44/01201.htm 3. Code of Virginia. Chapter 3. Interest and usury. Virginia’s Legislative Information System. Accessed March 10, 2023. https://law.lis.virginia.gov/vacodefull/title6.2/chapter3/#:~:text=Except

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This material is provided for informational purposes only, is subject to change, and should not be construed as legal or medical advice. Use of this information to challenge or appeal a coverage or reimbursement delay and/or denial by a payer is the responsibility of the provider.