How to Handle the National Provider Identifier (NPI) for Ordering/Referring and Attending/Operating/Other/Service Facility for Medicare Claims
In accordance with the NPI final rule, when an identifier is reported on a claim for ordering/referring provider, i.e., or for any provider that is not a billing, pay-to or rendering provider, that identifier must be an NPI. For Medicare purposes this means that submission of an NPI for an ordering/referring provider is mandatory effective May 23, 2008. Legacy numbers cannot be reported on any claims sent to Medicare on or after May 23, 2008. Medicare has always required that a provider identifier be reported for ordering/referring providers. Effective May 23, 2008, that number must be an NPI, regardless of whether that referring or ordering provider participates in the Medicare program or not or is a covered entity.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 26, 2007
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