Coverage profile
Work Medicare South Carolina 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 South Carolina Part B.
Other aliases
Also known as
- 11202
- 1484
- SCMCR
- SMSC0
- XMEDX
- Palmetto GBA (PGBA) - South Carolina
- South Carolina Medicare
- EPRO MEDICARE SOUTH CAROLINA PART B
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
9 days- 10% of adjudications by
- 7 days
- 90% of adjudications by
- 16 days
- Applicable state coverage
- SC
- Current As Of
- July 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 | 6 days | 14 days | 242 | SC |
| May | 10 days | 7 days | 14 days | 546 | SC |
| Jun | 9 days | 7 days | 14 days | 281 | SC |
| Jul | 9 days | 7 days | 16 days | 184 | SC |
| Aug | No qualified data | ||||
2027 maternity billing research
When does Medicare South Carolina Part B change OB/GYN billing?
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
- Transition start
- CY 2027 proposal; operational transition date not established
- Billing start
- Not established by cited proposal
- Published
- 2026-07-16
- Current As Of
- August 2026
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or South Carolina-specific MAC instructions.
CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.
Frequently asked questions
Medicare South Carolina Part B payer FAQs
What is the payer ID for Medicare South Carolina Part B?
The primary payer ID for Medicare South Carolina Part B is SMSC0. 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 South Carolina Part B?
The 837P payer ID for Medicare South Carolina Part B is SMSC0 via Stedi.
What is the 835 payer ID for Medicare South Carolina Part B?
The 835 payer ID for Medicare South Carolina Part B is SMSC0 via Stedi.
What is the 270 payer ID for Medicare South Carolina Part B?
The 270 payer ID for Medicare South Carolina Part B is SMSC0 via Stedi.
What state does Medicare South Carolina Part B operate in?
Medicare South Carolina Part B operates in SC.
Routing reference
Medicare South Carolina 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 South Carolina Part BSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | SCSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | SMSC0Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | SMSC0Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | SMSC0Enrollment 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 South Carolina 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 South Carolina 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
- (800) 448-6262EMPHESYS INSURANCE COMPANY, HUMANA INSURANCE CO. & HUMANA INSURANCE CO. OF NY
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 448-6262 | 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) 230-7338 | 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(619) 980-6944 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 235-5660 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 421-5077 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 460-8854 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 529-4917 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 867-5575 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 888-9355 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(973) 466-5503 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
Phone and fax numbers sourced directly from the payer response