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Expand PSC Data Transfer Files to Include a National Provider Identifier (NPI) for Each Legacy Provider Identifier

The Medicare Program Integrity Manual, chapter 4, section 28, requires that PSCs and affiliated contractors (ACs) establish joint operating agreements that include among other provisions procedures for requests for information. The CMS will require all Medicare providers to have a NPI by May 23, 2007. For Medicare billing purposes, that number will replace all current identifiers at that time. The same number will be used by any provider that bills any third party for reimbursement of health care. The CMS requires that the ACs, i.e., carriers, fiscal intermediaries, and durable medical equipment carriers, include an NPI for each legacy identifier in all applicable datasets they exchange with PSCs.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 01, 2007

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.