US · guidance
CMS Pub. 100-04, ch. 17, § 70.1.3
Inbound NCPDP Claim
The DME MAC needs to be able to determine whether a beneficiary has Medicaid coverage and in
which state. In order to determine this, the provider must enter the two position state alpha code
followed by the word “MEDICAID” in the Group ID field (Example, NYMEDICAID or
FLMEDICAID). Therefore, “XXMEDICAID” must be accepted in the Group ID field (301-C1) in
order to allow DME MAC’s to determine that a beneficiary has Medicaid coverage in that specific
state.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
20d069137fdfb701278035cdbe92e9be5bc44197d66030b0e2a7b89685698e87
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