Medical malpractice rules by state
Each state's cap on malpractice damages, whether you need an expert's affidavit or certificate to sue, and any notice or review panel required before a lawsuit.
General information only, not legal, insurance or financial advice. Not affiliated with any government agency. Rules have exceptions; open your state for details and the law it comes from.
| State | Damage cap | Expert affidavit or certificate | Before you sue |
|---|---|---|---|
| Alabama From a statute-cited table | No cap (struck down in 1991) | Not required | None required |
| Alaska From a statute-cited table | $250,000 noneconomic; $400,000 for wrongful death or severe permanent impairment | Not required | Court-appointed advisory panel after filing unless the parties arbitrate |
| Arizona From a statute-cited table | No cap (barred by the state constitution) | Preliminary expert affidavit served with initial disclosures if expert testimony is needed | None required |
| Arkansas From a statute-cited table | No cap (barred by the state constitution) | Statute required an affidavit within 30 days of filing, but courts have struck it down | None required |
| California From a statute-cited table | $470,000 noneconomic; $650,000 in death cases (2026, rising each year to 2033) | Not required | 90-day notice of intent to sue before filing (CCP 364) |
| Colorado From a statute-cited table | $530,000 noneconomic; $810,000 in death cases (for 2026 injuries, rising through 2029) | Certificate of review within 60 days after serving the complaint | None required |
| Connecticut From a statute-cited table | No cap | Similar-provider written opinion filed with the complaint | Mandatory mediation after filing |
| Delaware From a statute-cited table | No cap | Affidavit of merit and expert CV filed with the complaint | None required (review panel repealed in 2024) |
| District of Columbia From a statute-cited table | No cap | Not required | 90-day notice of intent before filing; mandatory mediation after filing |
| Florida From a statute-cited table | No cap (struck down in 2017) | Verified expert opinion with the notice of intent | Notice of intent and 90-day presuit investigation before filing |
| Georgia From a statute-cited table | No cap (struck down in 2010) | Expert affidavit filed with the complaint | None required |
| Hawaii From a statute-cited table | $375,000 on pain and suffering | Certificate of consultation with a physician | Mandatory medical inquiry and conciliation panel before suit |
| Idaho Under review | About $500,000 noneconomic (adjusted each year) | Not required | Mandatory prelitigation screening panel |
| Illinois From a statute-cited table | No cap (struck down in 2010) | Affidavit with a health professional's written report attached to the complaint | None required |
| Indiana From a statute-cited table | $1.8 million total for claims after June 2019 | Not required | Mandatory medical review panel before filing in court (small claims excepted) |
| Iowa From a statute-cited table | $1 million noneconomic ($2 million against hospitals); exceptions for some severe injuries | Certificate of merit within 60 days of the defendant's answer | None required |
| Kansas From a statute-cited table | No cap (struck down in 2019) | Not required | Screening panel on request of a party or the judge |
| Kentucky From a statute-cited table | No cap (barred by the state constitution) | Certificate of merit filed with the complaint | None required |
| Louisiana From a statute-cited table | $500,000 total, plus future medical care | Not required | Mandatory medical review panel before suit |
| Maine Under review | No cap in injury cases; separate cap on noneconomic damages in death cases | Not required | Notice of claim and mandatory prelitigation screening panel |
| Maryland From a statute-cited table | $920,000 noneconomic for 2026 claims (rises $15,000 a year); higher in some death cases | Certificate of qualified expert within 90 days of filing | Claims are filed first with the Health Care Alternative Dispute Resolution Office (parties may waive arbitration) |
| Massachusetts From a statute-cited table | $500,000 noneconomic, unless the injury is substantial or permanent | Not required | Medical malpractice tribunal reviews the claim after the answer |
| Michigan From a statute-cited table | About $600,000 noneconomic; about $1.07 million for catastrophic injuries (adjusted each year) | Affidavit of merit filed with the complaint | 182-day notice of intent before filing |
| Minnesota From a statute-cited table | No cap | Affidavit of expert review within 180 days of filing | None required |
| Mississippi From a statute-cited table | $500,000 noneconomic | Certificate of expert consultation filed with the complaint | 60-day notice of intent before filing |
| Missouri From a statute-cited table | About $481,000 noneconomic; about $843,000 for catastrophic injury or death (adjusted each year) | Health care affidavit within 90 days of filing | None required |
| Montana From a statute-cited table | $350,000 noneconomic in 2026, rising $50,000 a year to $500,000 in 2029 | Not required | Mandatory review by the Montana Medical Legal Panel before suit |
| Nebraska From a statute-cited table | $2.25 million total ($800,000 against qualifying providers) | Not required | Medical review panel before filing (claimant may waive) |
| Nevada From a statute-cited table | $590,000 noneconomic in 2026, rising to $750,000 by 2028 | Expert affidavit filed with the complaint | Mandatory settlement conference after filing |
| New Hampshire From a statute-cited table | No cap (struck down) | Not required | None required (screening panel repealed in 2023) |
| New Jersey From a statute-cited table | No cap | Affidavit of merit within 60 days of the answer | None required |
| New Mexico From a statute-cited table | About $770,000 for independent providers; higher for outpatient centers and hospitals | Not required | Medical review commission panel for qualifying providers |
| New York From a statute-cited table | No cap | Certificate of merit filed with the complaint (up to 90 days in some cases) | None required |
| North Carolina From a statute-cited table | About $713,000 noneconomic (adjusted every 3 years); no cap in some cases of reckless conduct | Rule 9(j) certification in the complaint that an expert reviewed the care | None required |
| North Dakota From a statute-cited table | $500,000 noneconomic | Expert opinion within 3 months of filing | Good-faith attempt at alternative dispute resolution |
| Ohio From a statute-cited table | $250,000, or 3 times economic loss up to $350,000 per plaintiff ($500,000 for catastrophic injury); death cases uncapped | Affidavit of merit filed with the complaint | 180-day letter can extend the 1-year deadline |
| Oklahoma From a statute-cited table | No cap (struck down in 2019) | Statute required an affidavit, but courts have struck it down | None required |
| Oregon From a statute-cited table | No cap (struck down in 2020) | Not required | Mandatory dispute resolution within 270 days of filing |
| Pennsylvania From a statute-cited table | No cap (barred by the state constitution) | Certificate of merit within 60 days of filing | None required |
| Rhode Island From a statute-cited table | No cap | Not required | None required |
| South Carolina From a statute-cited table | About $580,000 per provider; about $1.74 million total (adjusted each year) | Expert affidavit served with the notice of intent | Notice of intent and pre-suit mediation |
| South Dakota From a statute-cited table | $500,000 noneconomic | Not required | None required |
| Tennessee Under review | $750,000 noneconomic; $1 million for catastrophic injuries | Certificate of good faith filed with the complaint | 60-day pre-suit notice to each provider |
| Texas From a statute-cited table | $250,000 noneconomic against doctors; up to $500,000 more against facilities | Expert report within 120 days after each defendant answers | 60-day pre-suit notice with a medical authorization |
| Utah From a statute-cited table | $450,000 noneconomic | Certificate of compliance from the prelitigation panel | 90-day notice of intent and mandatory prelitigation panel review |
| Vermont From a statute-cited table | No cap | Certificate of merit filed with the complaint | None required |
| Virginia From a statute-cited table | $2.75 million total for acts from July 1, 2026 (rising $50,000 a year to $3 million) | Expert certification required before serving the defendant | Review panel on request of a party |
| Washington From a statute-cited table | No cap (struck down in 1989) | Not required (certificate of merit struck down in 2009) | Mandatory mediation before trial (pre-suit notice rule struck down in 2010) |
| West Virginia From a statute-cited table | About $375,000 noneconomic; about $750,000 for death or catastrophic injury (adjusted each year) | Screening certificate of merit with the notice of claim | Notice of claim at least 30 days before filing; provider may demand mediation |
| Wisconsin From a statute-cited table | $750,000 noneconomic per occurrence | Not required | Optional mediation (filing pauses the deadline) |
| Wyoming From a statute-cited table | No cap (barred by the state constitution) | Not required | None required |
How we checked this
Caps come from a statute-cited 2026 table and were compared with a second 50-state chart; caps that adjust every year are shown as approximate. Affidavit and panel rules come from the American Medical Association's State Laws Chart II (2025) and each state's notice statute. Last checked: November 12, 2026. Laws change; confirm with the state agency or a licensed professional before acting.
Cross-checked sources agree Checked on official source confirmed on a government, court or legislature site From a statute-cited table one detailed source Under review sources disagree; read the note and the law.