Medicaid (State Programs)
Also covers / subsidiaries: State Medicaid, MCO
Core Payer & Clearinghouse Profile
Electronic Payer ID
10125
Varies by state program and managed-care organization (MCO).
Timely Filing Limit (TFL)
Varies by state — commonly 90 to 365 days from the date of service
Appeal Window
Varies by state
Clearinghouse Gateway
Varies by state portal / clearinghouse
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
Varies — confirm via portal / clearinghouse
Each state runs its own Medicaid program and MCOs, each with its own payer ID, timely filing, and claims address. Confirm with the specific state plan.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Medicaid (State Programs).
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Medicaid (State Programs).
| 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 |
Resolution Tools for Medicaid (State Programs) 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. Last verified 2026-06-24.
Tired of Chasing Medicaid (State Programs) Denials & Delayed Payments?
Aethera's billing specialists work Medicaid (State Programs) every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.