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US · guidance

CMS Pub. 100-04, ch. 29, § 250.1

Amount in Controversy General Requirements

activein force · 2026-08-25 – presentas-observed

Each calendar year, the dollar threshold for the AIC requirement for ALJ hearing requests or judicial review

will be recalculated to reflect the percentage increase in the medical care component of the consumer price

index for all urban consumers (U.S. city average) for July 2003 to the July preceding the year involved. Any

amount that is not a multiple of $10 will be rounded to the nearest multiple of $10. Changes to the amount

in controversy threshold amounts are published annually in the Federal Register as per 42 CFR 405.1006(b).

Current AIC amounts, along with a link to the current Federal Register AIC Notice, can be found on the

CMS.gov website at: https://www.cms.gov/Medicare/Appeals -and-

Grievances/OrgMedFFSAppeals/OMHA -ALJ-Hearing.html

History

(Rev. 4380, Issued: 08-30-19, Effective: 07-08-19, Implementation: 10- 01-19)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
edc15a7fa31d97874a6059ccdd008442c350315d57c895e6175b7190f7e7d397
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