Coverage profile
Work Medicaid New York across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicaid New York.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medicaid New York.
Other aliases
Also known as
- 00812
- 100231
- 10155
- 12K35
- 141797357
- 1422
- CKNY1
- MCDNY
- NYCAID
- NYMCD
- SKNY0
- SKNY1
- NYSDOH
- New York State Department of Health
- New York State Medicaid
- eMedNY
- NEW YORK MEDICAID
- NY
- MEDICAIDNY
2027 maternity billing research
When does Medicaid New York change OB/GYN billing?
Effective immediately, NYS Medicaid FFS directs providers to use prenatal E/M CPT codes with TH and pregnancy-related O or Z ICD-10 diagnosis codes for individuals initiating prenatal care on or after June 1, 2026, and/or with an estimated due date on or after January 1, 2027. Initial prenatal visits must also include 0500F. The article separately states that current billing guidance applies through December 31, 2026 for members who established prenatal care before June 1, 2026. MMC plans must prepare systems and provider agreements/contracts for the specified prenatal alignment by June 1, 2026 and full AMA code-change implementation by January 1, 2027.
- Transition start
- 2026-06-01: prenatal-initiation threshold and MMC alignment deadline
- Billing start
- 2027-01-01: listed global-code cutoff and MMC full-implementation deadline
- Published
- 2026-04
- Current As Of
- August 2026
Scope: NYS Medicaid FFS medical-obstetric services, with express systems and provider agreement/contract requirements for NYS Medicaid Managed Care plans. No applicability to Dental, Vision or other Department of Health programs is established by this article.
New maternity care services coding changes. Verify the payer source before claim submission.
Frequently asked questions
Medicaid New York payer FAQs
Can I automate Medicaid New York portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Medicaid New York?
The primary payer ID for Medicaid New York is MCDNY. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Medicaid New York?
The provider portal for Medicaid New York is https://epaces.emedny.org/. Available features depend on the payer and your account.
What are the 837 payer IDs for Medicaid New York?
The 837P and 837I payer ID for Medicaid New York is MCDNY via Stedi.
What is the 835 payer ID for Medicaid New York?
The 835 payer ID for Medicaid New York is MCDNY via Stedi.
What is the 270 payer ID for Medicaid New York?
The 270 payer IDs for Medicaid New York are MCDNY via Stedi and 100231 and NY via Availity.
What is the 276 payer ID for Medicaid New York?
The 276 payer ID for Medicaid New York is MCDNY via Stedi.
What state does Medicaid New York operate in?
Medicaid New York operates in NY.
Routing reference
Medicaid New York payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Medicaid New YorkSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | NYSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | MCDNYEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | MCDNYEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | MCDNYEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | MCDNYSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 100231NYSource: Availity payer catalog · catalog dated · matched by payer name |
| 276 claim status payer IDStedi | MCDNYEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Medicaid New York. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer name; matched record: MEDICAID NEW YORK. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Medicaid New York. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Medicaid New York phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Eligibility / benefits phone
- (212) 563-5570ANTHEM HP LLC MAINSTREAM, ANTHEM HP LLC PARTIAL MLTC
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(212) 563-5570 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(212) 908-8569 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(315) 477-9565 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(518) 641-3000 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(585) 454-1700 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(607) 437-6237 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(646) 313-8967 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(646) 447-5000 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(646) 757-7000 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(718) 393-6170 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(718) 896-6500 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 223-7242 | Eligibility / benefits, Other stated contextBenefit context: Other or Additional Payor; Benefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 684-9286 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(845) 503-0570 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(855) 769-2500 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(866) 362-3368 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(866) 783-0222 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(877) 353-0185 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(888) 801-1660 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(917) 510-3551 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(952) 979-0119 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| phone(800) 207-1561 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 238-6279 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 821-4795 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(833) 203-1742 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 333-2757 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 724-0964 | PharmacyBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(516) 794-3000 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 228-9100 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 244-6224 | Dental, Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 255-5681 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 355-2583 | Dental, Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 444-6222 | Dental, Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 624-2414 | Dental, Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 676-2583 | Dental, Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 932-0783 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 942-0854 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 877-6187 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 238-6200 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 303-2414 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(180) 064-3484 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(212) 501-4444 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(513) 765-4142 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(518) 370-4793 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(518) 640-8100 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(646) 473-7160 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 206-4005 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 223-9870 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 225-0324 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 231-7729 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 234-6008 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 235-7267 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 241-7475 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 247-1447 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 275-2583 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 282-5366 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 321-0935 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 333-3883 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 345-3806 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 353-3765 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 444-5445 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 447-6689 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 447-8255 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 457-4708 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 457-4726 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 471-4685 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 490-6201 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 514-4912 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 517-6425 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 518-1638 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 521-3345 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 521-3605 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 523-5978 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 541-7846 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 552-0092 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 573-8597 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 603-6494 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 624-5060 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 633-6673 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 635-5783 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 638-3120 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 638-5433 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 643-4845 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 665-7924 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 722-1471 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 777-2273 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 818-1263 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 828-6922 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 832-3332 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 859-4417 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 877-7195 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 922-3242 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 962-2242 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 992-2583 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 999-5431 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(844) 434-7785 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(855) 340-7737 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(855) 696-4333 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(855) 731-1090 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 231-7201 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 422-5009 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 597-6674 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 633-2446 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 683-6440 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 723-0513 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 723-0515 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 856-9659 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 956-8488 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 989-8997 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 233-1800 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 234-4499 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 237-1840 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 258-3123 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 747-9578 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 769-7447 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 842-3625 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 224-4875 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 248-6522 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 260-1010 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 343-3547 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 356-7899 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 447-7703 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 477-4663 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 632-3862 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 636-6252 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 687-6277 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(972) 766-6900 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 343-9000 |
|
Phone and fax numbers sourced directly from the payer response
