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Medicaid as Secondary - Carrier Codes
Medicaid as Secondary - Carrier Codes

How to add a carrier code when billing Medicaid as a secondary ?

R
Written by Rachel
Updated over a week ago

When billing Medicaid as secondary payer, a Carrier Code for each primary insurance may need to be reported on electronic and paper claims. The Carrier Code reported is used as an identifier for Medicaid to recognize the primary payer. Not all states require the use of a Carrier Code.

States that Require a Carrier Code

  • Arkansas

  • Connecticut

  • Illinois

  • Louisiana

  • Massachusetts

  • New Hampshire

  • Pennsylvania

  • Rhode Island

  • South Carolina

  • Vermont

Each state Medicaid publishes their own list of carrier codes for primary insurances.

The Carrier Code is reported on the CMS-1500 and 837P electronic claim submission as follows:

  • On the CMS-1500 the Carrier Code value will be reported in box 9d.

  • On the 837P the Carrier Code value will be reported in:

    • Loop 2330B NM108 = PI

    • Loop 2330B NM109 = Carrier Code value

    • Loop 2430 SVD01 = Carrier Code value

Adding a Carrier Code

  1. Navigate to Management/Billing Setup/Payers and select the primary payer you want to add a carrier code for.

  2. Enter the Carrier Code in the Medicaid Carrier Code field and save your changes.

Illinois Medicaid requires that this other payer supplemental id be sent on the 837P in Loop 2330B REF Segment (REF01 = 2U and REF02 = Carrier Code Value).

This information needs to be added directly on an invoice where you need to report this.

  1. Click Modify on an invoice that you need to report this carrier code on.

  2. Click +Add on the Other Payer Supplemental ID(s).

  3. Select the primary payer available on the invoice in the Payer field dropdown.

  4. Select 2U-Payer Identification Number in the Type field dropdown.

  5. Enter the Identification Number for the primary payer as directed by Illinois Medicaid.

  6. Click Save to add your changes and you can now submit this invoice electronically.

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