Coverage profile
Work Medicare Massachusetts Part B 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 Medicare Massachusetts Part B.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medicare Massachusetts Part B.
Other aliases
Also known as
- 14212
- 2469
- 5527I
- JSMMA0
- MAMCR
- SMMA0
- Massachusetts Medicare
- National Government Services (NGS) - Massachusetts
- MEDICAREMA
2027 maternity billing research
When does Medicare Massachusetts Part B change OB/GYN billing?
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
- Transition start
- CY 2027 proposal; final transition date not established
- Billing start
- Not established in supplied proposal
- Published
- 2026-07-16
- Current As Of
- August 2026
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Massachusetts-specific MAC directive.
CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.
Frequently asked questions
Medicare Massachusetts Part B payer FAQs
Can I automate Medicare Massachusetts Part B 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 Medicare Massachusetts Part B?
The primary payer ID for Medicare Massachusetts Part B is 14212. 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 Medicare Massachusetts Part B?
The provider portal for Medicare Massachusetts Part B is https://www.ngsmedicare.com/. Available features depend on the payer and your account.
What is the 837P payer ID for Medicare Massachusetts Part B?
The 837P payer ID for Medicare Massachusetts Part B is 14212 via Stedi.
What is the 835 payer ID for Medicare Massachusetts Part B?
The 835 payer ID for Medicare Massachusetts Part B is 14212 via Stedi.
What is the 270 payer ID for Medicare Massachusetts Part B?
The 270 payer ID for Medicare Massachusetts Part B is 14212 via Stedi.
What state does Medicare Massachusetts Part B operate in?
Medicare Massachusetts Part B operates in MA.
Routing reference
Medicare Massachusetts Part B 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 | Medicare Massachusetts Part BSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | MASource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 14212Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 14212Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 14212Enrollment 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: Medicare Massachusetts Part B. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi 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
Medicare Massachusetts Part B 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
- (508) 799-2100FALLON COMMUNITY HEALTH PLAN
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(508) 799-2100 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(774) 701-1213 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(781) 612-1000 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(800) 200-4255 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(800) 624-0756 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(857) 282-3360 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(866) 296-8731 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(866) 420-9332 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(866) 676-6060 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(888) 867-5511 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(202) 942-1270 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(423) 954-6977 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(800) 448-6262 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 235-5660 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 309-1719 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 443-1095 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 460-8854 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 230-7338 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 543-4917 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 888-9355 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(920) 221-4087 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
Phone and fax numbers sourced directly from the payer response