Medicare Part B for billing teams
Payer ID, timely filing, appeals and prior authorization for fee-for-service medicare, from Medicare Part B's own documents, checked in October 2026.
What you get
- Payer IDs, filing limits and appeal deadlines
- A link to the payer's own document for each one
- An email when a payer changes a rule
Medicare Part B
Fee-for-service Medicare · checked in October 2026
- Payer ID for claims
- Set by each Medicare Administrative Contractor. For example, CGS uses 15202 for Ohio Part B.CGS EDI application
- Timely filing limit
- 1 calendar year from the date of service.42 CFR 424.44
- Appeal deadline
- 120 days from receiving the initial determination, which is presumed 5 days after the notice date.CMS, First level of appeal: redetermination
- Prior authorization
- Needed only for listed services, such as certain hospital outpatient procedures and some equipment and supplies, and under the WISeR model in 6 states from 2026.CMS, WISeR model
- Eligibility checks
- Real-time 270/271 checks through HETS, via a clearinghouse, or your contractor's portal.CMS, HIPAA Eligibility Transaction System
- Provider portal
- Your Medicare Administrative Contractor's own portal, such as myCGS.CMS Provider Communications Manual, chapter 6
- Provider phone
- Your Medicare Administrative Contractor. 1-800-MEDICARE is for patients.CMS, Contact your MAC