Medicare Texas Part B Payer ID 04412 — EDI, Portal & Claim Status

Coverage profile

How Substrate can help you with Medicare Texas Part B

Substrate can help practices and billers with the following claims tasks for Medicare Texas Part B.

Eligibility

EDI 270/271

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

Available

Portal claim status

Browser automation

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

Available

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 payment

View chart data as a table

Medicare Texas Part B observed adjudication timing by service month
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

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.

Medicare Texas Part B payer name, operating states, and transaction-specific payer IDs
Payer name	Medicare Texas Part B
Operating states	TX
837P professional claims payer IDStedi	`04412`Enrollment required
835 ERA payer IDStedi	`04412`Enrollment required
270 eligibility payer IDStedi	`04412`Enrollment required

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

Medicare Texas Part B payer phone and fax directory
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	MEDICAL MUTUAL OF OHIO	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	BAYLOR SCOTT & WHITE INSURANCE COMPANY	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	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 338-6833	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	DEVOTED HEALTH PLAN OF TEXAS, INC.	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	ARCADIAN HEALTH PLAN, INC. CARITEN HEALTH PLAN INC. CHA HMO, INC. EMPHESYS INSURANCE COMPANY HUMANA INSURANCE CO. & HUMANA INSURANCE CO. OF NY HUMANA INSURANCE COMPANY HUMANA MEDICAL PLAN, INC.	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 AND LIFE INSURANCE COMPANY AETNA HEALTH INC. (TX) AETNA HEALTH OF OHIO INC. AETNA LIFE INSURANCE COMPANY	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	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. PHYSICIANS HEALTH CHOICE OF TEXAS, LLC SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	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	MOLINA HEALTHCARE OF TEXAS, INC.	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	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	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	UNITEDHEALTHCARE OF WISCONSIN, INC.	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	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	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 COMMUNITY PLAN OF TEXAS, L.L.C.	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	HCSC INSURANCE SERVICES COMPANY MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	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 INSURANCE COMPANIES, INC. COMPCARE HEALTH SERVICES INSURANCE CORPORATION WELLPOINT INSURANCE COMPANY	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	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC WELLCARE PRESCRIPTION INSURANCE, INC.	Health Benefit Plan Coverage, Pharmacy
phone(202) 942-1270	PharmacyBenefit context: Other or Additional Payor	BLUE CROSS BLUE SHIELD ASSOCIATION	Pharmacy
phone(423) 954-6977	PharmacyBenefit context: Other or Additional Payor	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Pharmacy
phone(619) 980-6944	PharmacyBenefit context: Other or Additional Payor	MG INSURANCE COMPANY	Pharmacy
phone(866) 235-5660	PharmacyBenefit context: Other or Additional Payor	SILVERSCRIPT INSURANCE COMPANY	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) 327-1395	PharmacyBenefit context: Other or Additional Payor	HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC.	Pharmacy
phone(973) 466-5503	PharmacyBenefit context: Other or Additional Payor	HORIZON INSURANCE COMPANY	Pharmacy

Phone and fax numbers sourced directly from the payer response

Other aliases

Also known as

04412
1440
SMTX0
TXMCR
Novitas - Texas
MEDICARE