Tag Archives | npi

Home Health Agencies’ Claims for Ordered/Referred Services Must be Billed Using Individual Physician’s Name and NPI

In the near future, Regional Home Health Intermediaries (RHHIs) and Parts A and B Medicare Administrative Contractors (A/B MACs) will be contacting home health agencies (HHAs) that have previously submitted claims for ordered or referred services using a group name and national provider identifier (NPI).  HHAs will be informed they should begin submitting such claims using the ordering physician’s name and NPI, not a group name and NPI.  Once the Centers for Medicare & Medicaid Services (CMS) implements the edits for ordering/referring services into the coding system, claims submitted under a group NPI will be denied. Continue Reading →

CMS Releases Final Rule Requiring Providers to Include NPI on Enrollment and Claim Filings

The Centers for Medicare & Medicaid Services (CMS) just released a final rule requiring all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs.  The final rule will be published in the April 27th Federal Register, and the rule will become effective 60 days after publication, June 26.

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CMS Publishes List of Providers Already Requested to Revalidate

The Centers for Medicare & Medicaid Services (“CMS”) has posted a listing of providers who have already been sent a request to revalidate their Medicare enrollment information.  The listing contains the name and National Provider Identifier (“NPI”) of each provider, as well as the date the letter was sent.  Providers on the list, but have not received the request to revalidate should contact their Medicare Contractor.  This list will be updated monthly. 

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