National Centers for Medicare & Medicaid Services Payer ID CMS — EDI, Portal & Claim Status

Coverage profile

How Substrate can help you with National Centers for Medicare & Medicaid Services

Substrate can help practices and billers with the following claims tasks for National Centers for Medicare & Medicaid Services.

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with National Centers for Medicare & Medicaid Services.

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for National Centers for Medicare & Medicaid Services.

Available

Frequently asked questions

National Centers for Medicare & Medicaid Services payer FAQs

Can I automate National Centers for Medicare & Medicaid Services 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 National Centers for Medicare & Medicaid Services?

The primary payer ID for National Centers for Medicare & Medicaid Services is CMS. 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 National Centers for Medicare & Medicaid Services?

The provider portal for National Centers for Medicare & Medicaid Services is https://www.novitasphere.com. Available features depend on the payer and your account.

What is the 270 payer ID for National Centers for Medicare & Medicaid Services?

The 270 payer IDs for National Centers for Medicare & Medicaid Services are CMS via Stedi and CMS via Availity.

Routing reference

National Centers for Medicare & Medicaid Services 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.

National Centers for Medicare & Medicaid Services payer name, operating states, and transaction-specific payer IDs
Payer name	National Centers for Medicare & Medicaid Services
270 eligibility payer IDStedi	`CMS`Enrollment required
270 eligibility payer IDAvaility	`CMS`Enrollment required

Payer contact directory

National Centers for Medicare & Medicaid Services 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: (301) 816-6481KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES

National Centers for Medicare & Medicaid Services payer phone and fax directory
Channel and number	Payer Notes	Department	Specialties
phone(301) 816-6481	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Health Benefit Plan Coverage, Pharmacy
phone(443) 884-9082	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	ALTERWOOD ADVANTAGE, INC.	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(551) 225-2014	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	CLOVER INSURANCE COMPANY	Health Benefit Plan Coverage, Pharmacy
phone(614) 572-7033	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Health Benefit Plan Coverage, Pharmacy
phone(615) 636-4554	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(623) 806-3361	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	BRAVO HEALTH MID-ATLANTIC, INC. HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Health Benefit Plan Coverage, Pharmacy
phone(651) 662-3727	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	BCBSM, INC.	Health Benefit Plan Coverage
phone(781) 612-1000	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	TUFTS HEALTH PUBLIC PLANS, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 234-8755	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	MEDICA HEALTH PLANS	Health Benefit Plan Coverage, Pharmacy
phone(800) 247-1447	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	NEW YORK QUALITY HEALTHCARE CORPORATION	Health Benefit Plan Coverage, Pharmacy
phone(800) 299-1407	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	VOLUNTEER STATE HEALTH PLAN	Health Benefit Plan Coverage, Pharmacy
phone(800) 338-6833	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	DEVOTED HEALTH PLAN OF OHIO INC DEVOTED HEALTH PLAN OF TEXAS, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 344-8525	Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information	BLUE CARE NETWORK OF MICHIGAN	Health Benefit Plan Coverage
phone(800) 396-1942	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(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 INSURANCE COMPANY OF NEW YORK HUMANA MEDICAL PLAN, INC. HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	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. (NY) AETNA HEALTH INC. (TX) AETNA HEALTH OF MICHIGAN INC. 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 PREFERRED CARE PARTNERS, INC. SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UHC OF CALIFORNIA UNITEDHEALTHCARE BENEFITS OF TEXAS, INC. UNITEDHEALTHCARE OF THE MIDLANDS, INC. UNITEDHEALTHCARE OF WISCONSIN, 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 ILLINOIS INC	Health Benefit Plan Coverage, Pharmacy
phone(800) 831-2583	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Health Benefit Plan Coverage, Pharmacy
phone(800) 832-4643	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	UNITEDHEALTHCARE INSURANCE COMPANY	Health Benefit Plan Coverage, Pharmacy
phone(800) 926-6565	Eligibility / benefits, PharmacyBenefit context: Other or Additional Payor; Benefit context: Contact Following Entity for Eligibility or Benefit Information	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. FLORIDA BLUE MEDICARE, INC.	Health Benefit Plan Coverage, Pharmacy
phone(833) 570-6670	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	AETNA LIFE INSURANCE COMPANY ALLINA HEALTH AND AETNA INSURANCE COMPANY COVENTRY HEALTH AND LIFE INSURANCE COMPANY	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(855) 290-5744	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	CAREFIRST ADVANTAGE PPO, INC.	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	WELLMARK ADVANTAGE HEALTH PLAN, 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	HEALTH NET COMMUNITY SOLUTIONS, INC. MANAGED HEALTH SERVICES INSURANCE CORP. WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Health Benefit Plan Coverage, Pharmacy
phone(866) 309-1719	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	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. UNITEDHEALTHCARE OF NEW YORK, INC. UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC. UNITEDHEALTHCARE OF WISCONSIN, INC.	Health Benefit Plan Coverage, Pharmacy
phone(866) 579-8774	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.	Health Benefit Plan Coverage, Pharmacy
phone(866) 688-9021	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	ASTIVA HEALTH, INC.	Health Benefit Plan Coverage, Pharmacy
phone(866) 842-4968	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	UNITEDHEALTHCARE OF FLORIDA, INC.	Health Benefit Plan Coverage, Pharmacy
phone(888) 230-7338	Eligibility / benefits, PharmacyBenefit context: Other or Additional Payor; Benefit context: Contact Following Entity for Eligibility or Benefit Information	ANTHEM INSURANCE COMPANIES, INC. COMMUNITY INSURANCE COMPANY HEALTHKEEPERS, INC. WELLPOINT INSURANCE COMPANY WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	Health Benefit Plan Coverage, Pharmacy
phone(888) 296-9790	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Health Benefit Plan Coverage, Pharmacy
phone(888) 389-6648	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	PRIORITY HEALTH	Health Benefit Plan Coverage, Pharmacy
phone(888) 867-5511	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	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	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY NEW YORK QUALITY HEALTHCARE CORPORATION WELLCARE OF TEXAS, INC. WELLCARE PRESCRIPTION INSURANCE, INC.	Health Benefit Plan Coverage, Pharmacy
phone(952) 883-7699	Eligibility / benefits, PharmacyBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Other or Additional Payor	HEALTHPARTNERS, 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(717) 305-7388	PharmacyBenefit context: Other or Additional Payor	PSERS HOP PROGRAM	Pharmacy
phone(800) 517-6425	PharmacyBenefit context: Other or Additional Payor	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	Pharmacy
phone(800) 776-4466	PharmacyBenefit context: Other or Additional Payor	CALIFORNIA PHYSICIANS' SERVICE	Pharmacy
phone(833) 464-1010	PharmacyBenefit context: Other or Additional Payor	EXCELLUS HEALTH PLAN, INC.	Pharmacy
phone(866) 235-5660	PharmacyBenefit context: Other or Additional Payor	SILVERSCRIPT INSURANCE COMPANY	Pharmacy
phone(866) 421-5077	PharmacyBenefit context: Other or Additional Payor	BLUE CROSS AND BLUE SHIELD OF KANSAS	Pharmacy
phone(866) 443-1095	PharmacyBenefit context: Other or Additional Payor	OPTUM INSURANCE OF OHIO, INC.	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) 299-9062	PharmacyBenefit context: Other or Additional Payor	MODA HEALTH PLAN, INC.	Pharmacy
phone(877) 327-1395	PharmacyBenefit context: Other or Additional Payor	HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC.	Pharmacy
phone(877) 344-7364	PharmacyBenefit context: Other or Additional Payor	EMBLEMHEALTH PLAN, INC	Pharmacy
phone(877) 895-6448	PharmacyBenefit context: Other or Additional Payor	MEDCO CONTAINMENT LIFE & MEDCO CONTAINMENT NY & HE MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Pharmacy
phone(888) 543-4917	PharmacyBenefit context: Other or Additional Payor	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	Pharmacy
phone(888) 678-7009	PharmacyBenefit context: Other or Additional Payor	QCC INSURANCE COMPANY	Pharmacy
phone(888) 832-0075	PharmacyBenefit context: Other or Additional Payor	WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY	Pharmacy
phone(888) 867-5575	PharmacyBenefit context: Other or Additional Payor	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	Pharmacy
phone(920) 221-4087	PharmacyBenefit context: Other or Additional Payor	DEAN HEALTH INSURANCE, 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

10001
CMS
CMSMED
MAPMC
MEDICARE
Z1073
HETS
NATIONAL MEDICARE CMS
NATIONAL MEDICARE/CMS
NTNLMCRCMS