Medicare (Traditional) provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.cms.gov/medicare |
|---|---|
| Payer contact reference | Plan-specific |
| Claims payer ID | Confirm the Medicare fee-for-service MAC, jurisdiction, benefit type and transaction. CMS assigns EDI enrollment and support to A/B and DME MACs/CEDI; this source establishes no universal national claims ID. |
| Eligibility payer ID | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
| Timely filing | One calendar year after service; regulatory exceptions apply |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- Use the applicable MAC provider contact. The historical 1-800-MEDICARE number is for beneficiaries, not universal provider claims support.
- For Medicare fee-for-service services furnished from January 2010, 42 CFR 424.44 generally requires submission within one calendar year after service, with specified extensions and nonworkday handling. Confirm the applicable service and MAC instructions. This is not a Medicare Advantage filing rule or a fixed 365-day allowance.
- Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier.
Medicare (Traditional) at a glance
| Legal name | Centers for Medicare & Medicaid Services — Original Medicare (FFS) |
|---|---|
| Also known as | Original Medicare, Medicare Fee-for-Service, Medicare FFS, Medicare Part A/B |
| Category | Government program |
| Parent organization | Centers for Medicare & Medicaid Services (CMS) |
| Claims payer ID | Confirm the Medicare fee-for-service MAC, jurisdiction, benefit type and transaction. CMS assigns EDI enrollment and support to A/B and DME MACs/CEDI; this source establishes no universal national claims ID. |
| Eligibility (270/271) payer ID | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
| NAIC company code | Not established in this registry |
| States covered | Nationwide (50 states) |
| Members covered | ~34 million members |
| Provider resource entry point | https://www.cms.gov/medicare |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Medicare (Traditional)
For Medicare fee-for-service services furnished from January 2010, 42 CFR 424.44 generally requires submission within one calendar year after service, with specified extensions and nonworkday handling. Confirm the applicable service and MAC instructions. This is not a Medicare Advantage filing rule or a fixed 365-day allowance.
| Submission type | Window |
|---|---|
| Initial claim reference | One calendar year after service; regulatory exceptions apply |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
Reconsideration and appeal routes
- Redetermination (MAC)File within 120 days
First-level appeal filed with the MAC within 120 days of the initial determination (42 CFR §405.942).
- Reconsideration (QIC)File within 180 days
Reconsideration by a Qualified Independent Contractor within 180 days of the redetermination.
- ALJ HearingFile within 60 days
Administrative Law Judge hearing for amounts in controversy meeting the annual threshold.
- Medicare Appeals CouncilFile within 60 days
Review by the Medicare Appeals Council of the Departmental Appeals Board.
- Federal District CourtFile within 60 days
Judicial review in federal district court for claims meeting the amount-in-controversy threshold.
Source: Medicare (Traditional) provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Medicare (Traditional)
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Medicare (Traditional) electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Medicare (Traditional). Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Medicare (Traditional)
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Medicare (Traditional) volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | Confirm the Medicare fee-for-service MAC, jurisdiction, benefit type and transaction. CMS assigns EDI enrollment and support to A/B and DME MACs/CEDI; this source establishes no universal national claims ID. |
| 270 / 271 eligibility | Listed in registry; verify current scope | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| 278 prior authorization | Not established; verify separately | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone
Source comparison: 2026-09-26
CMS routes provider claims and coverage inquiries to the applicable MAC. The stored 1-800-MEDICARE number is identified for beneficiaries, not universal provider support.
Primary source for provider_phonetimely_filing_days
Source comparison: 2026-09-26
For services furnished from January 2010, the regulation generally uses one calendar year after service, with specified extensions and nonworkday handling. Medicare Advantage routing is outside this fee-for-service rule.
Primary source for timely_filing_dayspayer_ids.claims
Source comparison: 2026-09-26
CMS assigns EDI enrollment and transaction support to A/B and DME MACs/CEDI; a universal national claims ID is not established.
Primary source for payer_ids.claims
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.eligibility / payer_ids.era / era_payer_id: No transaction-specific universal eligibility/ERA identifier established; do not copy a claims ID.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
Evaluate QuickIntell workflow fit for Medicare (Traditional)
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Medicare (Traditional); verify the actual plan rules and available connections before implementation.
- QuickCode
Evaluate documentation and coding-review controls for Medicare (Traditional); require applicable sources and qualified review rather than assuming payer-specific edits are configured.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Medicare (Traditional) before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Medicare (Traditional)
Where is the Medicare (Traditional) provider portal?
Use https://www.cms.gov/medicare as a starting point for Medicare (Traditional) provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Medicare (Traditional)?
For Medicare fee-for-service services furnished from January 2010, 42 CFR 424.44 generally requires submission within one calendar year after service, with specified extensions and nonworkday handling. Confirm the applicable service and MAC instructions. This is not a Medicare Advantage filing rule or a fixed 365-day allowance.
Does Medicare (Traditional) publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Medicare (Traditional). Claims: Confirm the Medicare fee-for-service MAC, jurisdiction, benefit type and transaction. CMS assigns EDI enrollment and support to A/B and DME MACs/CEDI; this source establishes no universal national claims ID.. Eligibility (270/271): Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing.. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Medicare (Traditional) accept electronic claims?
Verify Medicare (Traditional) electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Medicare (Traditional) denial?
Identify the product, state and reason for the decision before choosing a Medicare (Traditional) dispute route. The listed starting route is Redetermination (MAC) (File within 120 days). First-level appeal filed with the MAC within 120 days of the initial determination (42 CFR §405.942). Verify the controlling notice and exceptions; reconsideration, appeal and external review are not always a mandatory sequence.
How long do Medicare (Traditional) prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact Medicare (Traditional)?
This registry has not established one provider phone number for Medicare (Traditional). Use the applicable MAC provider contact. The historical 1-800-MEDICARE number is for beneficiaries, not universal provider claims support. Use https://www.cms.gov/medicare as a starting point for Medicare (Traditional) provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
Automate workflows around Medicare (Traditional) requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Medicare (Traditional)'s current published documents before submission. CPT® is a registered trademark of the American Medical Association.