Coverage profile
How Substrate can help you with Medicare Virginia Part B
Substrate can help practices and billers with the following claims tasks for Medicare Virginia Part B.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicare Virginia 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
- 14 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 | 9 days | 5 days | 52 days | 140 | SC |
| May | 9 days | 5 days | 14 days | 276 | SC |
| Jun | 10 days | 6 days | 16 days | 250 | SC |
| Jul | 9 days | 7 days | 14 days | 215 | SC |
| Aug | No qualified data | ||||
2027 maternity billing research
When does Medicare Virginia 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 Virginia Part B payer FAQs
What is the payer ID for Medicare Virginia Part B?
The primary payer ID for Medicare Virginia Part B is 11302. 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 Virginia Part B?
The 837P payer ID for Medicare Virginia Part B is 11302 via Stedi.
What is the 835 payer ID for Medicare Virginia Part B?
The 835 payer ID for Medicare Virginia Part B is 11302 via Stedi.
What is the 270 payer ID for Medicare Virginia Part B?
The 270 payer ID for Medicare Virginia Part B is 11302 via Stedi.
What state does Medicare Virginia Part B operate in?
Medicare Virginia Part B operates in VA.
Routing reference
Medicare Virginia 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 Virginia Part BSource: Substrate payer directory · last refreshed |
|---|---|
| Operating states | VASource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | 11302Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 11302Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 11302Enrollment 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 Virginia 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 Virginia 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 Virginia 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
- (614) 572-7033COVENTRY HEALTH CARE OF VIRGINIA, INC.
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(614) 572-7033 | 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) 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) 457-8506 | 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) 927-6048 | 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(866) 235-5660 | PharmacyBenefit context: Other or Additional Payor |
| Pharmacy |
| phone(866) 443-1095 | 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) 543-4917 | 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 and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 11302
- 1442
- SMVA0
- VAMCR
- Palmetto GBA (PGBA) - Virginia
- MEDICARE B - VA