Coverage profile
How Substrate can help you with Medicare South Dakota Part B
Substrate can help practices and billers with the following claims tasks for Medicare South Dakota Part B.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicare South Dakota Part B.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medicare South Dakota Part B.
2027 maternity billing research
When does Medicare South Dakota Part B change OB/GYN billing?
Transition begins 2027-01-01. CMS proposes valuing the new CPT codes but is considering 15 Medicare-specific global maternity HCPCS codes GMAT1-GMAT15 instead.
- Transition start
- 2027-01-01
- Billing start
- Not published
- Published
- 2026-07-16
- Current As Of
- August 2026
Scope: federal Medicare Part B proposal; MAC instructions pending
CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.
Frequently asked questions
Medicare South Dakota Part B payer FAQs
Can I automate Medicare South Dakota 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 South Dakota Part B?
The primary payer ID for Medicare South Dakota Part B is 03402. 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 South Dakota Part B?
The provider portal for Medicare South Dakota Part B is https://www.noridianmedicareportal.com/web/nmp/home. Available features depend on the payer and your account.
What are the 837 payer IDs for Medicare South Dakota Part B?
For professional claims, use 03402 via Stedi. For institutional claims, use 03402 via Stedi.
What is the 835 payer ID for Medicare South Dakota Part B?
The 835 payer ID for Medicare South Dakota Part B is 03402 via Stedi.
What is the 270 payer ID for Medicare South Dakota Part B?
The 270 payer ID for Medicare South Dakota Part B is 03402 via Stedi.
What state does Medicare South Dakota Part B operate in?
Medicare South Dakota Part B operates in SD.
Routing reference
Medicare South Dakota 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 Dakota Part BSource: Substrate payer directory · last refreshed |
|---|---|
| Operating states | SDSource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | 03402Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 03402Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 03402Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 03402Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Medicare South Dakota 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 Dakota 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) 234-8755MEDICA HEALTH PLANS, MEDICA INSURANCE COMPANY
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 234-8755 | 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) 643-4845 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(855) 716-2556 | 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) 460-8854 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 529-4917 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 230-7338 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(888) 832-0075 | 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
Other aliases
Also known as
- 03402
- 2454
- SDMCR
- SMSD0
- Noridian (NHS) - South Dakota
- MEDICARESD
- MEDICARE NORIDIAN