Check eligibility on Medicare NY Part B Upstate. Payer ID 13282

Coverage profile

Work Medicare New York Part B Upstate 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 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicare New York Part B Upstate.

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for Medicare New York Part B Upstate.

Not enough data

Other aliases

Also known as

13282
1463
JSB807
JSMNY0
JSMNY2
N1MCR
NYMCR
SB807
SMNY0
SMNY2
National Government Services (NGS) - New York
MEDICARE NEW YORK UPSTATE PART B
MEDICARENY

2027 maternity billing research

When does Medicare New York Part B Upstate change OB/GYN billing?

Federal proposal—not final

For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.

Transition start: CY 2027 proposal; exact transition date not established
Billing start: Not established by this source
Published: 2026-07-16
Current As Of: August 2026

Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.

Open Medicare New York Part B Upstate in the payer explorer →

View Payer Policy ↗Upstream page ↗

CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.

Frequently asked questions

Medicare New York Part B Upstate payer FAQs

Can I automate Medicare New York Part B Upstate 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 New York Part B Upstate?

The primary payer ID for Medicare New York Part B Upstate is 13282. 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 New York Part B Upstate?

The provider portal for Medicare New York Part B Upstate is https://www.ngsmedicare.com/. Available features depend on the payer and your account.

What is the 837P payer ID for Medicare New York Part B Upstate?

The 837P payer ID for Medicare New York Part B Upstate is 13282 via Stedi.

What is the 835 payer ID for Medicare New York Part B Upstate?

The 835 payer ID for Medicare New York Part B Upstate is 13282 via Stedi.

What is the 270 payer ID for Medicare New York Part B Upstate?

The 270 payer ID for Medicare New York Part B Upstate is 13282 via Stedi.

What state does Medicare New York Part B Upstate operate in?

Medicare New York Part B Upstate operates in NY.

Routing reference

Medicare New York Part B Upstate 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.

Medicare New York Part B Upstate payer name, operating states, and transaction-specific payer IDs
Payer name	Medicare New York Part B UpstateSource: Substrate payer directory · data last changed Sep 25, 2026
Operating states	NYSource: Substrate payer directory · data last changed Sep 25, 2026
837P professional claims payer IDStedi	`13282`Enrollment requiredSource: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
835 ERA payer IDStedi	`13282`Enrollment requiredSource: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID
270 eligibility payer IDStedi	`13282`Enrollment requiredSource: Stedi payer catalog · catalog dated Aug 8, 2026 · matched by payer ID

Routing sources and verification

Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed Sep 25, 2026; checked Oct 22, 2026.Open payer website ↗
Stedi payer catalogMatched by payer ID; matched record: Medicare New York Part B Upstate. Source dated Aug 8, 2026.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 New York Part B Upstate 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: (518) 991-3775MVP HEALTH PLAN, INC.

Medicare New York Part B Upstate payer phone and fax directory
Channel and number	Payer Notes	Department	Specialties
phone(518) 991-3775	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	MVP HEALTH PLAN, INC.	Health Benefit Plan Coverage, Pharmacy
phone(551) 225-2014	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	CLOVER INSURANCE COMPANY	Health Benefit Plan Coverage, Pharmacy
phone(615) 636-4554	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	BRAVO HEALTH PENNSYLVANIA, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 247-1447	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	NEW YORK QUALITY HEALTHCARE CORPORATION	Health Benefit Plan Coverage, Pharmacy
phone(800) 448-6262	Eligibility / benefits, PharmacyBenefit context: Other or Additional Payor; Benefit context: Contact Following Entity for Eligibility or Benefit Information	HUMANA INSURANCE CO. & HUMANA INSURANCE CO. OF NY HUMANA INSURANCE COMPANY HUMANA INSURANCE COMPANY OF NEW YORK	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	AETNA HEALTH INC. (NY)	Health Benefit Plan Coverage, Pharmacy
phone(800) 643-4845	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 832-4643	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	UNITEDHEALTHCARE INSURANCE COMPANY	Health Benefit Plan Coverage, Pharmacy
phone(800) 926-7526	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Health Benefit Plan Coverage, Pharmacy
phone(844) 876-6176	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Health Benefit Plan Coverage, Pharmacy
phone(866) 480-1086	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	UNITEDHEALTHCARE OF NEW YORK, INC.	Health Benefit Plan Coverage, Pharmacy
phone(888) 230-7338	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	ANTHEM HP, LLC.	Health Benefit Plan Coverage, Pharmacy
phone(888) 801-1660	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	HEALTHFIRST HEALTH PLAN, INC.	Health Benefit Plan Coverage, Pharmacy
phone(888) 888-9355	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	NEW YORK QUALITY HEALTHCARE CORPORATION WELLCARE PRESCRIPTION INSURANCE, INC.	Health Benefit Plan Coverage, Pharmacy
phone(423) 954-6977	PharmacyBenefit context: Other or Additional Payor	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Pharmacy
phone(866) 235-5660	PharmacyBenefit context: Other or Additional Payor	SILVERSCRIPT INSURANCE COMPANY	Pharmacy
phone(866) 309-1719	PharmacyBenefit context: Other or Additional Payor	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Pharmacy
phone(866) 443-1095	PharmacyBenefit context: Other or Additional Payor	OPTUM INSURANCE OF OHIO, INC.	Pharmacy
phone(866) 460-8854	PharmacyBenefit context: Other or Additional Payor	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	Pharmacy
phone(866) 529-4917	PharmacyBenefit context: Other or Additional Payor	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Pharmacy
phone(877) 344-7364	PharmacyBenefit context: Other or Additional Payor	EMBLEMHEALTH PLAN, INC	Pharmacy

Phone and fax numbers sourced directly from the payer response