Amount in controversy thresholds climbing in 2026

Effective Dec 14, 2025

Published Dec 14, 2025

Last Reviewed Dec 15, 2025

CMS is updating the dollar amount in controversy required to sustain appeal rights for an Administrative Law Judge (ALJ) hearing or Federal District Court review in 2026.

In order to request a hearing by an ALJ, the amount remaining in controversy must meet the threshold requirement. That amount will climb to $200 for hearing requests filed in 2026, up from $190 in 2025.

If the case reaches the Federal District Court, the amount in controversy must be at least $1,900 in 2025. For reviews in the Federal District Court in 2026, that amount climbs to $1,960.

For more on the appeals process, see:

https://www.cms.gov/files/document/mln006562-medicare-parts-b-appeals-process.pdf

The information contained herein was current as of the publication date. © Copyright DecisionHealth, all rights reserved. Electronic or print redistribution without prior written permission of DecisionHealth is strictly prohibited by federal copyright law.