CGS Administrators Medicare — Jurisdiction 15
Also covers / subsidiaries: CGS, CGS Administrators, J15, Jurisdiction 15
Core Payer & Clearinghouse Profile
Electronic Payer ID
10125
A/B MAC Jurisdiction 15 — Kentucky and Ohio. CGS also serves as a DME MAC (Jurisdictions B & C). EDI payer IDs vary by transaction.
Timely Filing Limit (TFL)
1 calendar year from date of service (Medicare FFS statutory limit)
Appeal Window
Redetermination: 120 days from receipt of the Remittance Advice / initial determination
Clearinghouse Gateway
National Clearinghouse / EDI Gateway
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://www.cgsmedicare.com/
CGS Administrators is the MAC for Jurisdiction 15, covering KY and OH, and also operates as a DME MAC.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for CGS Administrators Medicare — Jurisdiction 15.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under CGS Administrators Medicare — Jurisdiction 15.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Edic | J1289 | Non-Par | None | Workers Comp |
| Edic | WB021 | Non-Par | None | Workers Comp |
| Medica | 10125 | Non-Par | None | 837P837I270/271276/277Dental |
| Medica | 94265 | Non-Par | Required | 837P837I835 ERA |
| Medicare | 00431 | Non-Par | None | 837P837I270/271Dental |
Resolution Tools for CGS Administrators Medicare — Jurisdiction 15 Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
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