Palmetto GBA New Medicare Provider Guide

This guide will teach you everything you need to know to be a Medicare provider and submit claims electronically to Palmetto GBA. To get started, please select your Medicare jurisdiction below:

Jurisdiction J

mapJJPart APart B

Jurisdiction M

mapJMPart APart B

Jurisdiction M HH&H

mapHHHHome Health and Hospice

Railroad Medicare

mapRRPart B Nationwide

National Provider Enrollment (NPE) West

mapNPENational Provider Enrollment

What is my Medicare jurisdiction?

Please reference the list below to determine if you are a Part A or Part B Medicare provider.

Part A Providers

  • Community Mental Health Centers (CMHCs)
  • Comprehensive Outpatient Rehabilitation Facilities (CORFs)
  • Critical Access Hospitals (CAHs)
  • End-Stage Renal Disease (ESRD) Facilities
  • Federally Qualified Health Centers (FQHCs)
  • Histocompatibility Laboratories
  • Home Health Agencies (HHAs)
  • Hospice Organizations
  • Hospitals
  • Indian Health Service (IHS) Facilities
  • Organ Procurement Organizations
  • Outpatient Physical Therapy/Occupational Therapy/Speech-Language Pathology Services
  • Religious Non-Medical Health Care Institutions
  • Rural Health Clinics
  • Skilled Nursing Facilities (SNFs)

Part B Providers

  • Anesthesiology Assistants
  • Audiologists
  • Certified Nurse-Midwives
  • Chiropractor
  • Clinical Nurse Specialists
  • Clinical Psychologists
  • Clinical Social Workers
  • Mass Immunization Roster Billers, Individuals
  • Nurse Practitioners
  • Optometrist
  • Physical/Occupational Therapists in Private Practice
  • Physicians (Doctors of Medicine or Osteopathy, Doctors of Dental Medicine, Dental surgery, Podiatric Medicine, or Optomerty)
  • Physician Assistants
  • Psychologists Practicing Independently
  • Registered Dietitians or Nutrition Professionals
  • Speech-Language Pathologists
Clinics/Group Practices and Certain Other Suppliers
  • Ambulance Service Suppliers
  • Ambulatory Surgical Centers (ASCs)
  • Clinics/Group Practices
  • Independent Clinical Laboratories
  • Independent Diagnostic Testing Facilities (IDTFs)
  • Intensive Cardiac Rehabilitation Suppliers
  • Mammography Centers
  • Mass Immunization Roster Billers, Entities
  • Medicare Diabetes Prevention Program (MDPP) Supplier
  • Opioid Treatment Programs (OTPs)
  • Pharmacy
  • Physical/Occupational Therapy Group in Private Practice
  • Portable X-Ray Suppliers
  • Radiation Therapy Centers

What is Jurisdiction M Home Health and Hospice?

Palmetto GBA processes Part A, fee-for-service Medicare claims for Medicare beneficiaries through home health agencies and hospices in the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas.

What is Railroad Medicare?

Palmetto GBA is the Railroad Retirement Board Specialty Medicare Administrative Contactor (RRB SMAC). We process Part B fee-for-service claims for Railroad Medicare beneficiaries nationwide. If you are a Part B Medicare provider, you are eligible to provide care to Railroad Medicare patients, but you will need to request and receive a Railroad Medicare Provider Transaction Access Number (PTAN) before we can process your claims. This PTAN is required because Railroad Medicare does not overlap with your local Medicare contractor.