Coverage profile
Work Medicare North Carolina Part B (Jurisdiction 11) 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 North Carolina Part B (Jurisdiction 11).
Other aliases
Also known as
- SMNC0
- Palmetto GBA (PGBA) - North Carolina
- MEDICARE NORTH CAROLINA PART B (J11)
Payer intelligence
Observed adjudication timing
How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.
Median time to payment
7 days- 10% of adjudications by
- 7 days
- 90% of adjudications by
- 14 days
- Applicable state coverage
- SC
- Current As Of
- August 2026
Five-month median trend
Days to 835 paymentView chart data as a table
| Service month | Median | 10% of adjudications by | 90% of adjudications by | Completed claims | Coverage |
|---|---|---|---|---|---|
| Apr | 10 days | 7 days | 16 days | 180 | SC |
| May | 9 days | 7 days | 14 days | 441 | SC |
| Jun | 9 days | 7 days | 14 days | 648 | SC |
| Jul | 7.9 days | 7 days | 15 days | 475 | SC |
| Aug | 7 days | 7 days | 14 days | 142 | SC |
2027 maternity billing research
When does Medicare North Carolina Part B (Jurisdiction 11) change OB/GYN billing?
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.
CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.
Frequently asked questions
Medicare North Carolina Part B (Jurisdiction 11) payer FAQs
What is the payer ID for Medicare North Carolina Part B (Jurisdiction 11)?
The primary payer ID for Medicare North Carolina Part B (Jurisdiction 11) is SMNC0. 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 837P payer ID for Medicare North Carolina Part B (Jurisdiction 11)?
The 837P payer ID for Medicare North Carolina Part B (Jurisdiction 11) is SMNC0 via Stedi.
What is the 835 payer ID for Medicare North Carolina Part B (Jurisdiction 11)?
The 835 payer ID for Medicare North Carolina Part B (Jurisdiction 11) is SMNC0 via Stedi.
What is the 270 payer ID for Medicare North Carolina Part B (Jurisdiction 11)?
The 270 payer ID for Medicare North Carolina Part B (Jurisdiction 11) is SMNC0 via Stedi.
What state does Medicare North Carolina Part B (Jurisdiction 11) operate in?
Medicare North Carolina Part B (Jurisdiction 11) operates in NC.
Routing reference
Medicare North Carolina Part B (Jurisdiction 11) 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 North Carolina Part B (Jurisdiction 11)Source: Substrate payer directory · data last changed |
|---|---|
| Operating states | NCSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | SMNC0Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | SMNC0Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | SMNC0Enrollment 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 North Carolina Part B (Jurisdiction 11). 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 North Carolina Part B (Jurisdiction 11) 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.
- Pharmacy phone
- (800) 448-6262HUMANA INSURANCE CO. & HUMANA INSURANCE CO. OF NY
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 448-6262 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 460-8854 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 296-9790 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 888-9355 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
Phone and fax numbers sourced directly from the payer response