Coverage profile
Work Medicare Texas 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 Texas Part B.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medicare Texas Part B.
Other aliases
Also known as
- 04412
- 1440
- SMTX0
- TXMCR
- Novitas - Texas
- MEDICARE
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
8 days- 10% of adjudications by
- 4 days
- 90% of adjudications by
- 14 days
- Applicable state coverage
- PA
- 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 | 7 days | 4 days | 14 days | 117 | PA |
| May | 7 days | 4 days | 14 days | 234 | PA |
| Jun | 7 days | 2 days | 14 days | 199 | PA |
| Jul | 8 days | 4 days | 14 days | 142 | PA |
| Aug | No qualified data | ||||
2027 maternity billing research
When does Medicare Texas Part B change OB/GYN billing?
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
- Transition start
- CY 2027 proposal; no operative transition date established
- Billing start
- Not established by cited proposal
- Published
- 2026-07-16
- Current As Of
- August 2026
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Texas-specific MAC instructions.
CY 2027 Physician Fee Schedule proposed rule. Verify the payer source before claim submission.
Frequently asked questions
Medicare Texas Part B payer FAQs
Can I automate Medicare Texas 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 Texas Part B?
The primary payer ID for Medicare Texas Part B is 04412. 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 Texas Part B?
The provider portal for Medicare Texas Part B is https://www.novitasphere.com. Available features depend on the payer and your account.
What is the 837P payer ID for Medicare Texas Part B?
The 837P payer ID for Medicare Texas Part B is 04412 via Stedi.
What is the 835 payer ID for Medicare Texas Part B?
The 835 payer ID for Medicare Texas Part B is 04412 via Stedi.
What is the 270 payer ID for Medicare Texas Part B?
The 270 payer ID for Medicare Texas Part B is 04412 via Stedi.
What state does Medicare Texas Part B operate in?
Medicare Texas Part B operates in TX.
Routing reference
Medicare Texas 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 Texas Part BSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | TXSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 04412Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 04412Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 04412Enrollment 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 Texas Part B. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Medicare Texas Part B. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse 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 Texas 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
- (216) 687-2807MEDICAL MUTUAL OF OHIO
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(216) 687-2807 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(512) 257-6136 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(623) 806-3361 | 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) 338-6833 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage |
| 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(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(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(800) 665-0898 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(844) 310-2247 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(844) 855-9774 | 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) 480-1086 | Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor |
| Health Benefit Plan Coverage, Pharmacy |
| phone(877) 895-6448 | 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(888) 888-9355 | 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) 460-8854 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 529-4917 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(877) 327-1395 | 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