Have you gotten your National Provider Identifier (NPI) yet? Even if you do not bill Medicare for services, you may be required to have an NPI by your employer and third-party payers, or if you plan to electronically bill third-party payers in the future. Without the NPI, claims may be adversely affected, with payment delayed or possibly denied.
Audiologists should be aware that the Centers for Medicare & Medicaid Services (CMS) will now require use of their own NPI when billing for Medicare services from a physician office. However, audiologists will have until October 1, 2008 to obtain their NPI and Medicare provider number. Speech-language pathologists cannot obtain their own Medicare provider number, but can and should have an NPI number. Remember, getting an NPI is free—not having one could be costly. Please go to ASHA's Take Action site to contact your Senators about the bill (S. 45) that would allow SLPs in private practice to bill Medicare.
Additional NPI information specifically for audiologists and speech-language pathologists can be found on the NPI page on the ASHA Web site. For questions, please contact reimbursement@asha.org.
The following information, sent out by CMS on April 24, 2008, is important for all providers, Medicare and non-Medicare.
Are You Prepared? May 23rd is Only 4 Weeks Away
The NPI will be required for all HIPAA Standard Transactions on May 23rd. This means:
- For all primary and secondary provider fields, only the NPI will be accepted and sent on all HIPAA electronic transactions, paper claims, and SPR remittance advice.
- The reporting of Medicare legacy identifiers in any primary or secondary provider fields will result in the rejection of the transaction.
Now that the NPI is required on all Medicare claims in the primary provider fields, if your claims are being successfully processed with NPI/legacy pairs (and most are) now is the time to begin sending a small batch of claims with the NPI alone. If the Medicare NPI Crosswalk cannot match your NPI to your Medicare legacy number, the claim with an NPI-only will reject. You can and should try sending NPI-only now! For specific steps to begin using the NPI alone in the primary provider identifier fields, go to the CMS Communications Web page.
Sending a sample of NPI-only claims will allow time for any needed corrections prior to May 23, 2008, the date when only the NPI will be accepted in all provider fields.
Check with Other Health Plans to Understand May 23rd Expectations
CMS encourages all health care providers to contact other health plans with which you interact in order to ensure you fully understand their expectations for May 23, 2008.
Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page on the CMS Web site. Providers can apply for an NPI online or call the NPI enumerator to request a paper application at 1-800-465-3203.
Note: The entire contents of this announcement and past CMS NPI communications are available at the CMS Communications page on the CMS Web site.
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