Medicare Fights Cost $200 More in 2027 Appeals
Published Date: 9/16/2026
Notice
Summary
This notice announces the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2027. The calendar year 2027 AIC threshold amounts are $200 for ALJ hearings and $2,000 for judicial review.
Analyzed Economic Effects
3 provisions identified: 0 benefits, 3 costs, 0 mixed.
ALJ Hearing Threshold Set at $200
If you are on Medicare and want an Administrative Law Judge (ALJ) hearing, you must have at least $200 in dispute for requests filed on or after January 1, 2027. The CY 2027 amount in controversy (AIC) threshold for ALJ hearings is $200.
Judicial Review Threshold Raised to $2,000
If you are on Medicare and want judicial review in court, the amount in controversy must be at least $2,000 for requests filed on or after January 1, 2027. The CY 2027 AIC threshold for judicial review increased from $1,960 in CY 2026 to $2,000 in CY 2027.
Thresholds Apply Across Medicare Parts and Plans
The CY 2027 AIC thresholds apply to Medicare Part A and Part B appeals and also apply to Medicare Part C (Medicare Advantage), Medicare Part D (prescription drug plans), health maintenance organizations, competitive medical plans, and health care prepayment plans for ALJ hearings and judicial review. These application rules are effective for requests filed on or after January 1, 2027.
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