Palmetto GBA Medicare — Jurisdiction M
Also covers / subsidiaries: Palmetto GBA, JM, Jurisdiction M
Core Payer & Clearinghouse Profile
Electronic Payer ID
10125
A/B MAC Jurisdiction M — North Carolina, South Carolina, Virginia, and West Virginia. EDI payer IDs vary by transaction and clearinghouse.
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://palmettogba.com/jmb
Palmetto GBA is the MAC for Jurisdiction M, covering NC, SC, VA, and WV.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Palmetto GBA Medicare — Jurisdiction M.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Palmetto GBA Medicare — Jurisdiction M.
| 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 Palmetto GBA Medicare — Jurisdiction M 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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