NPI: Get it. Share it. Use it.
August 23rd marks 9 months remaining until the National Provider Identifier (NPI) compliance date. Over 1 million NPIs have been issued so far --- do you have your NPI yet? At this 9-month mark, the Centers for Medicare & Medicaid Services (CMS) would like to announce the following:
CMS NPI Roundtable - September 26, 2006
- CMS will host a national NPI Roundtable, open to all health care professionals, on Tuesday, September 26th from 2:00-3:30PM ET.
- To participate, you may call 1-877-203-0044, pass code 4795739
- CMS will address common questions related to Medicare's guidance on Subparts. While CMS will only address questions from a Medicare perspective, this information may be helpful to all providers. Medicare providers, who have questions, should select the appropriate email below and send in questions by Friday, September 8th. Questions received after this date will not be considered.
- Medicare providers who bill a Fiscal Intermediary should send questions to:
NPIQuestionsfromFIBillers@cms.hhs.gov - Medicare providers who bill a Carrier should send questions to:
NPIQuestionsfromCarrierBillers@cms.hhs.gov - Medicare providers who bill a Durable Medical Equipment Regional Carrier (DMERC) should send questions to:
NPIQuestionsfromDMERCBillers@cms.hhs.gov
Think You Don't Need an NPI? Think Again.
- Even those providers who do not bill for services may need to disclose their NPIs to those providers who do (e.g., physicians who order lab tests or refer patients for diagnostic testing must be identified on the lab's or testing facility's claims).
- Even if you plan to retire in April, but know that some of your claims will not be submitted until after the May 23rd compliance date, you still need an NPI. Without the NPI, those claims may be adversely affected, with payment delayed or possibly even denied.
Reminder to Supply Legacy Identifiers on NPI Application
- CMS continues to urge providers to include legacy identifiers on their NPI applications. This will help all health plans, including Medicare, to get ready for May 23, 2007. If reporting a Medicaid legacy number, include the associated State name. If providers have already been assigned NPIs, CMS asks them to consider going back into the NPPES and updating their information with their legacy identifiers if they did not include those identifiers when they applied for NPIs. This information is critical for health plans and health care clearinghouses in the development of crosswalks to aid in the transition to the NPI.
New NPI Slogans and Partnership with WEDI
- Recently, CMS and the Workgroup for Electronic Data Interchange (WEDI) agreed to common NPI slogans for use in outreach campaigns. These slogans appear at the beginning and end of this listserv message, and will continue to appear on our messages and products. A recent WEDI press release, found at
http://www.wedi.org/npioi/public
/articles/dis_viewArticle.cfm?ID=537
, discusses the slogans and partnership in more detail.
Special Information for Medicare Providers
Designation of Subparts
- CMS reminds Medicare providers to visit Medicare's Subparts Expectation Paper (located at http://www.cms.hhs.gov/NationalProvIdentStand/
Downloads/Medsubparts01252006.pdf
on the CMS NPI web page) for more suggestions on how to determine their subparts. Remember, no health plan, not even Medicare, can instruct a provider on how to enumerate subparts. This is a business decision that the organization provider must make considering its unique business operations.
Medicare Provider Enrollment and NPIs
- " CMS requires that providers and suppliers obtain their NPIs prior to enrolling in Medicare or updating their Medicare enrollment information. Providers and suppliers must enter their NPIs on the CMS-855 Medicare provider enrollment applications and submit a copy of their NPI notifications with each CMS-855 application that they submit.
Required Use of NPI on Medicare Paper Claim Forms
- Medicare will require the NPI on its paper claim forms. To learn more visit a recent MLN Matters article on this topic at http://www.cms.hhs.gov/MLNMattersArticles
/downloads/mm4023.pdf on the CMS website.
Medicare DME Suppliers and NPIs
- CMS issued a special communication regarding DME suppliers and the NPI which can be viewed at http://www.cms.hhs.gov/NationalProvIdentStand
/Downloads/npi_dme_comm.pdf on the CMS website.
Medicare to Require Taxonomy Codes on Institutional Claims
- Effective January 1, 2007, institutional Medicare providers (e.g., hospitals, HHAs, SNFs) who submit claims for their primary facility and its subparts must report a taxonomy code on all claims submitted to their Fiscal Intermediary. To learn more, visit a recent MLN Matters article at http://www.cms.hhs.gov/MLNMattersArticles
/downloads/mm5243.pdf on the CMS website.
Use of NPI on Medicare Claims on October 1st
- Beginning October 1st, Medicare can accept claims that only have an NPI on them, however, to facilitate further testing, Medicare strongly encourages its providers to submit both legacy identifiers and their NPI on claims.
As always, more information and education on the NPI can be found at the CMS NPI page
http://www.cms.hhs.gov/NationalProvIdentStand
on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203.
Getting an NPI is free - not having one can be costly.
Page Last Updated: Monday, 09-Jun-2008 15:27:02 CDT
