CMS Updates Medicare Appeals Amount in Controversy Threshold Amounts for CY26

The Centers for Medicare & Medicaid Services (CMS) published a notice announcing 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, 2026. The calendar year (CY) 2026 AIC threshold amounts are $200 for ALJ hearings and $1,960 for judicial review. These thresholds apply to Medicare Part A, Part B and Medicare Advantage​ ALJ hearings and judicial review levels of the appeals process. 

Below is a table of the CYs 2022 through 2026 threshold amounts: