Submit a Reconsideration

The second level of appeal is the reconsideration request and is carried out by the QIC.

• Time limit to initiate = 180 days from date of receipt of redetermination decision
• Time limit to complete the review = 60 days
• Amount in controversy = no minimum amount

Go to the Original Medicare (Fee-for-service) Appeals page on the CMS website for additional information regarding reconsiderations and QICs.

Submit Your Reconsideration

In Writing

Please complete the CMS-20033 Medicare Reconsideration Request Form or the reconsideration request form included with the redetermination decision.

Send the completed CMS-20033 Medicare Reconsideration Request Form to the QIC appeals mailing address:

C2C Innovative Solutions, Inc.- QIC Part B North
P.O. Box 45208
Jacksonville, FL 32232-5028

Reviewed 11/21/2024