Medicare-participating healthcare providers who have multiple subparts (i.e., psychiatric units, rehabilitation units, etc.) should be able to use one National Provider Identifier (NPI) even after the May 23rd deadline set by CMS for processing NPI-only claims, CMS announced on April 25th.
The NPI is a unique identification number for covered health care providers. Over the past few years Medicare providers have been transitioning from using other types of legacy identifiers in their claims to using the NPI. Medicare Claims Processing Manual, Pub. 100-04, Transmittal No. 1133, Dec. 19, 2006, allowed providers to submit claims for their primary facility using a single NPI and then non-NPI taxonomy codes for each subpart provider. CMS would then use a crosswalk to ensure that the provider received the proper reimbursement for each subpart.
On April 3, CMS notified all Medicare providers that the NPI crosswalk was not working, adding "Medicare will only accept/send NPI-only transactions beginning May 23rd and providers need to understand from these other plans [the subparts] what will happen if they are unable to send/receive NPI-only transaction."
The provider community reacted with concern that after May 23rd claims that included non-NPI identifiers for subpart units would not be processed. In its April 25th statement, CMS stressed, "We believe that your claims will be successfully processed using your NPI, regardless of whether you enumerate your subparts with NPIs." CMS emphasized, however, the providers should still get individual NPIs for their subparts as soon as possible.
Source: CCH Chicago Bureau, May 1, 2008.
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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