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Reporting the National Provider Identifier (NPI) on Claims for Reference Laboratory and Purchased Diagnostic Services Performed Outside the Billing Jurisdiction

This instruction gives clarification on billing instructions on the use of the NPI on Medicare claims for reference laboratory or purchased diagnostic service when the service is performed outside of the billing jurisdiction. The billing provider shall report their own NPI with the name, address, and zip code of the performing physician/supplier. This also supplements and manualizes CR 5289 which was issued October 27, 2006 as Transmittal 243.

Download the Guidance Document

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

Issue Date: February 27, 2009

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.