What is the National Provider Identifier (NPI) Requirement?
As a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the federal Department of Health and Human Services has mandated the use of the National Provider Identifier (NPI). On January 23, 2004, CMS defined and published the Governing Rules for NPI. NPIs replace Provider Numbers assigned by Medicare, Medicaid, local carriers and other federal programs for HIPAA Transactions. The Final Rules placed responsibility on health plans, health care clearinghouses and covered health care providers to obtain a NPI number, rather than on the states to assign them.
Related Questions
- When a provider is billing Medi-Cal for a surgery, do they need to include the facility’s National Provider Identifier (NPI) on the claim?
- When are providers required to bill Medi-Cal using their National Provider Identifier (NPI) on the new CMS-1500 claim form?
- What is the National Provider Identifier (NPI) Requirement?
