National Government Services Logo

Note: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material which is copyrighted by the American Medical Association (AMA). You are forbidden to download the files unless you read, agree to and abide by the provisions of the copyright statement. Read the copyright statement now (you will be linked back to here).

MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)

   
MM5795 Update to Requirement to Submit National Provider Identifier (NPI) Notification

MLN Matters Number: MM5795 Related Change Request (CR) #: 5796
Related CR Release Date: November 2, 2008 Effective Date: January 1, 2008
Related CR Transmittal #: R227PI Implementation Date: January 7, 2008

Provider Types Affected
Physicians, providers and suppliers, except durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier, (hereinafter collectively referred to as “providers”) who bill Medicare contractors (carriers, fiscal intermediaries (FI), Part A/B Medicare Administrative Contractors (A/B MAC) and Regional Home Health Intermediaries (RHHI)) for claims for services provided to Medicare beneficiaries

What Providers Need to Know
Providers, except DMEPOS suppliers, are no longer required to submit to the Medicare contractor a copy of the NPI notification received from the National Plan and Provider Enumeration System (NPPES), unless requested to do so by the contractor. Similarly, if the provider, except DMEPOS supplier, obtained the NPI via the Electronic File Interchange (EFI) mechanism, the provider need not submit a copy of the notification received from the EFI Organization (EFIO), unless requested to do so by the contractor. If paper documentation of a provider’s NPI is requested by the contractor, the contractor may accept a copy of the provider’s NPI Registry’s Details Page in lieu of a copy of the NPI notification.

Additional Information
If you have questions, please contact your Medicare A/B MAC, FI, RHHI, or carrier at their toll-free number which may be found at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zipzip on the CMS Web site.

You may see the official instruction (CR5795) issued to your Medicare A/B MAC, FI, RHHI, or carrier by going to http://www.cms.hhs.gov/Transmittals/downloads/R227PI.pdfexternal pdf on the CMS Web site.

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2006 American Medical Association.

News Flash - A new preventive services brochure entitled Cancer Screenings, ICN# 006434, is now available on the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network (MLN). This tri-fold brochure provides health care professionals with an overview of Medicare’s coverage of the following screening services: mammography, colorectal, prostate, Pap test, and pelvic exam. The brochure is available at http://www.cms.hhs.gov/MLNProducts/downloads/Cancer_Screening.pdfexternal pdf on the CMS Web site.

Posted: 12/07/2007
CMS Logo
CPT codes, descriptions, and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.