Patient refund laws by state (21 states)

It depends on your state and the kind of provider. Most of the state rules we read give 30 days. Some give 45 (New Mexico and North Carolina) or 60 (Colorado, Delaware and Virginia). Each rule has conditions, and the days often start when the provider determines you overpaid or when you ask, not on the day you paid.

If you paid a doctor or hospital more than you owed, the extra money often sits on your account as a credit balance. We searched the law of every state and Washington, D.C. Below are 21 states: 15 with a refund rule for medical bills and 6 with a rule for people on Medicaid, plus the federal rules that apply in every state. This page is about money a patient paid. Rules on insurers taking back payments from providers are different and are not covered here. The rules differ in who they cover, what counts as an overpayment and what starts the clock, so the conditions matter. This is general information, not legal advice.

Patient refund laws by state: the short list

Each rule has conditions, so read its row in the tables below before you rely on it.

30 days: California (doctors and dentists, for a duplicate payment), Florida, Maine, Maryland, Minnesota, Nevada, Texas and Washington.
45 days: New Mexico and North Carolina.
60 days: Colorado, Delaware and Virginia.
No set number of days: Rhode Island and Utah.
Medicaid rules: Arizona, Massachusetts, Oregon, Pennsylvania, Tennessee and Wisconsin. Only Tennessee, for long-term care facilities, sets a number of days (10).
Every state: Medicare providers, and nonprofit hospitals after a financial assistance application is approved. Neither sets a fixed refund deadline.

Rules we checked in the law itself (checked October 9, 23 and 30, 2026)

We list a rule only after reading it in the statute or regulation. Each row gives who the rule covers and its conditions. Laws change, so the source link is the place to confirm the current text.

Where	Who it covers	Deadline or rule	Source
California	Physicians and dentists (not hospitals), only for a duplicate payment: you paid for a service, and an insurer or other third-party payer later paid for the same service	If you ask: within 30 days of your request, or within 30 days of receiving the insurer's payment if it had not arrived yet. If you do not ask: they must tell you within 90 days of when they knew, or should have known, of the duplicate payment, and refund within 30 days unless you ask to keep a credit.	Bus. & Prof. Code s. 732
Colorado	Out-of-network providers who gave emergency care at any facility, or covered nonemergency care at an in-network facility	If you are covered by a health plan and paid for care that Colorado's surprise billing law (section 10-16-704) says you were not responsible for: reimburse within 60 calendar days after the overpayment was reported to the provider. If late, interest at 10% a year from the date of the notice.	C.R.S. s. 12-30-113
Colorado	Out-of-network facilities that gave emergency care	Same rule: reimburse within 60 calendar days after the overpayment was reported to the facility, with interest at 10% a year if late.	C.R.S. s. 25-3-122
Delaware	Large health care facilities (licensed hospitals, outpatient clinics run under a hospital license or majority-owned by a hospital, and licensed freestanding emergency departments) and medical debt collectors collecting for them	If you paid more than you owe after any financial assistance or charity care the facility offers: refund within 60 days. The law does not say when the 60 days start. Payments made before a change in your finances made you eligible do not have to be refunded.	6 Del. C. s. 2505J(f)
Florida	Facilities licensed by the Agency for Health Care Administration, such as hospitals and ambulatory surgical centers, that billed a government program, private insurer or HMO for your care	Refund no later than 30 days after the facility determines you overpaid. In effect since January 1, 2026. Does not apply to overpayments under Florida's claim payment rules for insurers and HMOs (sections 627.6131 and 641.3155).	Fla. Stat. s. 408.12
Florida	Licensed health care practitioners, and billing offices, management companies and group practices that collect for them, when they billed a government program, private insurer or HMO for your care	Refund no later than 30 days after the practitioner determines you overpaid. In effect since January 1, 2026. Same exclusion for insurer and HMO overpayments.	Fla. Stat. s. 456.0625
Maine	Out-of-network providers, such as doctors, hospitals and ambulance services, when you are in a health plan and paid for covered care you were not responsible for, such as a surprise bill or out-of-network emergency care, above your in-network deductible, copay or coinsurance	Reimburse you within 30 calendar days after the earlier of the day the provider got notice of the overpayment and the day it became aware of it. If late, interest at 10% a year from that same day.	22 M.R.S. s. 1718-D
Maryland	Hospitals	If you were found eligible for free care within 240 days after the first bill: refund of amounts over $25 collected from you or your guarantor, no later than 30 days after the hospital determines you were eligible. If you are in a means-tested government health plan that requires you to pay part of the cost, the refund follows that plan's terms.	Health-General s. 19-214.2(c)
Minnesota	Hospitals, licensed or registered health professionals and group practices that bill you, when they learn from you or anyone else that a bill may contain a mistake that affects what you owe	They must review the bill, and may not bill you for the services under review while the review runs. If the review shows you overpaid: refund within 30 days after completing the review. In effect since October 1, 2024.	Minn. Stat. s. 62J.808
Nevada	Doctors, hospitals and other providers, when a workers' compensation insurer denied a claim for a work injury or illness and you, or your health insurer, paid the provider	If you paid more than Nevada's workers' compensation rules allow the provider to be paid: reimburse the excess within 30 days after receiving notice of it.	NRS 616C.138(7)
New Mexico	Out-of-network providers, when you have a health plan and paid more than your in-network cost sharing for care that New Mexico's Surprise Billing Protection Act treats as a surprise bill	Refund what you paid above your in-network cost sharing within 45 calendar days of receiving your insurer's payment, with interest if late. If it is not refunded, you can appeal to the Office of Superintendent of Insurance within 180 days after the 45 days end.	NMSA s. 59A-57A-6, 13.10.33.8 NMAC
North Carolina	Hospitals and ambulatory surgical facilities licensed in North Carolina	If you paid more than the amount due, whatever the cause, insurance coverage included: refund within 45 days of receiving notice of the overpayment. Does not apply while the overpayment is in dispute or on appeal. A state rule makes hospitals put this 45-day refund in their written billing policies.	N.C. Gen. Stat. s. 131E-91(b), 10A NCAC 13B .3502
Rhode Island	Any health care provider, when a patient 65 or older is billed for health care services never provided to them and reports it to the state's Office of Healthy Aging	Once verified, the provider must repay the amount and also pay the patient 10% of it. Hospital billings paid by DRG, the fixed rate per hospital stay, are exempt from the 10%. No number of days.	R.I. Gen. Laws s. 5-37-23
Texas	Physicians, hospitals and other health care providers paid by an enrollee in a health plan covered by Insurance Code chapter 1661 (Medicaid, CHIP and some other coverage are left out)	Refund no later than the 30th day after the provider determines there was an overpayment. Does not apply to overpayments under separate Texas rules for HMOs and insurers (sections 843.350 and 1301.132).	Ins. Code s. 1661.005
Texas	Physicians licensed in Texas, when a patient overpays	Refund no later than the 30th day after the physician determines there was an overpayment. Same exclusions for HMO and insurer overpayments.	Occ. Code s. 101.352(h)
Utah	Health care providers, when you have more than one insurer, the provider has contracts with them, and the provider learns it was paid more than its contracted rate allows	Return what you overpaid, with interest that starts 90 days after the date of the overpayment. No fixed refund deadline.	Utah Code s. 31A-26-301.5(4)
Virginia	Large health care facilities: hospitals licensed in Virginia and their outpatient clinics, and practices that provide outpatient care with at least $20 million in yearly revenue (or a medical debt collector, as set in a debt sale agreement)	If you paid more than you owed on a medical debt, after any financial assistance the facility offered: refund within 60 days after the excess payment is determined.	Va. Code s. 59.1-612(G)
Washington	Hospitals licensed in Washington, psychiatric hospitals included, when you paid part or all of the charges and are later found to have met the charity care criteria at the time of care	Payments above the amount found appropriate under the state's charity care rules must be refunded within 30 days of the charity care designation.	WAC 246-453-020(11)
Every state: nonprofit hospitals	Tax-exempt hospitals under federal section 501(r), when you submit a complete financial assistance application during the application period and are found eligible	Refund what you paid for that care above what you owe as an eligible patient, unless the excess is under $5 (or another amount the IRS sets). The rule says "in a timely manner" and sets no number of days.	26 CFR 1.501(r)-6
Every state: Medicare	Providers with a Medicare provider agreement, for amounts collected from a Medicare patient that the agreement rules do not allow	Prompt refund is the preferred method. If the provider cannot refund within 60 days from the date on the notice of incorrect collection, it must set the amount aside in a separate account for the patient. No fixed refund deadline.	42 CFR 489.41

For nonprofit hospitals, the application period starts on the date of care and runs at least until the 240th day after the first bill the hospital gives you after you are discharged. Our guide on refund after hospital financial assistance explains how to apply after you paid.

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If you have Medicaid

Sometimes you pay a provider and Medicaid later pays the provider for the same care, for example because your coverage was found to start before the visit. These state rules say the provider must then pay you back.

Where	Who it covers	Rule	Source
Arizona	Providers registered with AHCCCS, Arizona's Medicaid program, for covered services in your prior quarter eligibility period (months before you applied that AHCCCS covers)	Once AHCCCS pays the provider, it must reimburse everything you paid for those services. No number of days.	R9-22-703(H)(2)
Massachusetts	Providers paid by MassHealth, when you paid before they knew you were a MassHealth member at the time of the service	Once the provider learns you were a member, it must immediately return everything it collected from you for that service.	130 CMR 450.203(B)
Oregon	Providers in the Oregon Health Plan	If the provider took payment from you or your representative and the Oregon Health Authority later pays it for the same service: reimburse the full amount you paid. No number of days.	OAR 410-120-1280(10)(f)(E)
Pennsylvania	Providers paid by Medical Assistance (Medicaid)	A provider that accepts an extra payment from you for a service or item Medical Assistance pays for must return it. No number of days.	55 Pa. Code s. 1101.63(a)
Tennessee	A facility under TennCare's long-term services and supports rules that took an advance payment or deposit for a period when you were later found eligible for Medicaid	Refund what was collected, minus your share set by the state for that period, within 10 days after the facility receives Medicaid's payment for that period.	1200-13-01-.09(2)
Wisconsin	Medicaid providers that billed you directly for services in a period you were later found eligible for	After Medicaid pays the claims for that period, reimburse in full you or whoever paid, up to the amount Medicaid paid. No number of days.	DHS 106.04(3)(b)

Tell the provider you have Medicaid for the date of service and ask it to bill Medicaid. Your state Medicaid agency can confirm when your coverage started.

If your state is not listed

This page is not a list of every state's rules. We searched the law of every state, but some state law websites could not be opened, and a state may also have a refund rule in a licensing rule or the provider's own policy. Nursing homes and assisted living have their own refund rules in several states, which this page does not cover. Not being listed here does not mean your state has no rule.

Where to ask:

The billing office. Ask whether your account shows a credit balance, how much, and which payment created it. Ask for its refund policy in writing. If you paid an interest charge or a late fee that looks off, ask about it too: see interest and late fees on a medical bill. If you paid a deposit before a procedure, see asked to pay before surgery.
Your state insurance department, especially if the overpayment involves your insurer's payment or your plan's rules.
Your state attorney general's consumer protection office.

The nonprofit hospital and Medicare rows apply in every state, under their conditions.

When the clock starts

In most of the rules above, the days do not start on the day you paid.

California: when you ask for the refund, or when the insurer's payment arrives if that is later. If you do not ask, the doctor or dentist has 90 days from when they knew, or should have known, of the duplicate payment to tell you.
Colorado: when the overpayment was reported to the provider or facility.
Delaware: the law does not say when its 60 days start.
Florida and Texas: when the provider determines there was an overpayment.
Maine: the earlier of the day the provider got notice of the overpayment and the day it became aware of it.
Maryland: when the hospital determines you were eligible for free care.
Minnesota: when the provider completes its review of the bill.
Nevada and North Carolina: when the provider receives notice of the overpayment.
New Mexico: when the out-of-network provider receives your insurer's payment.
Utah: interest starts 90 days after the date of the overpayment itself.
Virginia: when the excess payment is determined.
Washington: when the hospital designates you for charity care.

If you think you overpaid, asking in writing gives the billing office the dates and amounts to check, and gives you a dated record of when you told them. In Colorado, Maine, Nevada and North Carolina, the days in the rules above count from when the provider was told.

How to ask for the refund

Check what you paid against your share. Add up every payment for the visit and compare it with your share on your insurer's Explanation of Benefits for the same date of service. Our guide on overpaying a medical bill shows how to spot a credit balance.
Call the billing office. Ask whether your account shows a credit balance and ask for the payment history.
Ask in writing. Our free refund request letter asks the billing office to confirm the credit balance and refund it to you. If a rule in the table covers your situation, you can mention it.
Keep a record. Keep copies, and write down the date you sent the request and who you spoke to.

If you paid the provider yourself and your insurer never got the claim, our guide on how to get reimbursed by insurance shows how to send it yourself. If you do not hear back, our guide on how to dispute a medical bill covers next steps. Only the provider can confirm what your account shows, and only your insurer can confirm your share.

Check your own bill

You can read your bill free on MedBillCheckup. A few optional questions, such as how much you have already paid, let the checks look for a payment above your share. The bill is read on your device, and the file stays with you. The free check shows how many things are worth asking about, and the largest amount worth asking about if there is one. The full list, which is paid, shows every item, why, and the exact question to ask. Check your bill free.

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Questions about this guide

Which states have a patient refund law?

Among the rules we read in the law itself, 15 states have one for medical bills and 6 more have one for people on Medicaid. Eight give 30 days (California, Florida, Maine, Maryland, Minnesota, Nevada, Texas and Washington), two give 45 days (New Mexico and North Carolina) and three give 60 days (Colorado, Delaware and Virginia). Rhode Island and Utah set no number of days. Each rule has conditions, listed in the table, and your state may have one we could not read. Only the provider can confirm what your account shows.

How long does a hospital have to refund an overpayment?

It depends on the state and the kind of provider. Among the rules we checked, Florida and Texas set 30 days after the provider determines there was an overpayment (in Florida, when the provider billed a government program, insurer or HMO for your care; in Texas, for enrollees in health plans that Texas law covers, with some plans such as Medicaid and CHIP left out). North Carolina sets 45 days after a hospital or surgery center receives notice of the overpayment. Delaware and Virginia set 60 days for large facilities. Each rule has conditions, listed in the table. Only the provider can confirm what your account shows.

Do doctors have to refund an overpayment within 30 days?

In some states, under conditions. In Florida, a licensed practitioner who billed a government program, insurer or HMO for your care must refund within 30 days after determining you overpaid. In Texas, a physician must refund within 30 days after determining there was an overpayment, except overpayments under separate rules for HMOs and insurers. In Minnesota, doctors and other providers must refund within 30 days after completing a review of a bill that may contain a mistake affecting what you owe. In California, doctors and dentists must refund a duplicate payment within 30 days after you ask (or after the insurer payment arrives, if later), when an insurer also paid for the same service. Ask the billing office for its refund policy in writing.

What if my state is not in the table?

We searched the law of every state and Washington, D.C., but we list only rules we could read in the law itself, and some state law websites could not be opened, so your state may still have one. Ask the billing office for its refund policy, and if that does not help, your state insurance department or your state attorney general consumer protection office. If a nonprofit hospital found you eligible for financial assistance, or you have Medicare, the federal rules in the table may apply wherever you live.

I paid a bill, then got Medicaid for that date. Can I get the money back?

Ask the provider to bill Medicaid for that date and to refund what you paid once Medicaid pays. Arizona, Massachusetts, Oregon, Pennsylvania and Wisconsin have rules saying a Medicaid provider must pay back what you paid for care Medicaid pays for, under the conditions in the Medicaid table below, and Tennessee has one for long-term care facilities. Only the provider and your state Medicaid agency can confirm your dates and what you owe.

Sources

Paid more than you owed on a medical bill? How to ask for the money back
How a credit balance happens, how to spot it, and how to ask for the money back in writing.
Paid a medical bill yourself? How to get your insurer to pay you back
How to send your own claim after you paid: what to attach, the deadlines, and what to do if the plan pays less.
How to question, dispute or contest a medical bill
A step-by-step way to get a charge explained or changed, with a free dispute letter to send.
Medical bill vs EOB: how to compare them
An EOB (Explanation of Benefits) is the statement your insurer sends after a claim: what it allowed, what it paid and what you may owe. It is not a bill.
Paid a hospital bill, then qualified for financial assistance?
What hospital financial assistance is, how the rules treat money you already paid, and how to apply and ask for a refund.

Free tools

Itemized bill request letter
Ask the provider for every charge, line by line.
Refund request letter
Ask for a credit balance back when you paid more than your share.
Financial assistance request letter
Ask a hospital for its financial assistance policy and application form.
Charity care check
See whether you may qualify for a hospital’s financial assistance.
Letter to a collection agency
Dispute a medical debt, or ask the agency for verification.
Medical bill dispute letter
Ask the billing office about the charges you type.
Insurance claim file request letter
Ask a health plan for the documents behind a decision on a claim.
Medical bill code lookup
Medicare’s name for a drug, supply or equipment code on your bill.
Health money dates 2027
Open enrollment, FSA, Medicare and tax dates for 2027, each with its source.
Medical bill glossary
The words and abbreviations on bills and EOBs, explained.

How long does a provider have to refund a patient overpayment?