When we bill clinic option services and SPO services, will we use the NPI # assigned to our CSB only or will we use both the agency NPI # and the individual # assigned to each of our licensed staff?
DMAS crosswalked each Medicaid ID to an NPI. The CSB will use their NPI to submit claims for services as they do now in lieu of their Medicaid ID. In the scenario mentioned, you would bill for the clinic option services and SPO services using only the Agency NPI. Long Term Care and Subparts I do the billing for personal care, respite care and private duty for several locations. Each location has their own Medicaid provider number that claims are billed under. Do I need to get an NPI for each location and one for personal care, respite care, and private duty? Each legal entity, or separate Tax ID, should obtain an NPI if it conducts healthcare transactions using that Tax ID Number. In addition, DMAS would recommend that organizations follow the Medicare guidelines with respect to subparts. Each location or line of business that is separately surveyed or certified by Medicare should obtain an NPI as a subpart. Please refer to the following guidance: cms.hhs.gov/NationalProvIdentStand/npi
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