NPI Deadline Reminder – March 1, 2008

In the January National Provider Identifier (NPI) message issued recently by CMS, providers were reminded of the quickly approaching March 1, 2008 deadline for use of NPI numbers on claims. Fee for service providers and suppliers were reminded that as of March 1, 2008 providers will not be able to get paid for any Medicare services they provide until they begin using their NPI.

  • Claims with both an NPI and a Medicare legacy number will continue to be rejected if the pair is not found on the Medicare NPI crosswalk.
  • Claims without an NPI in the primary provider field will be rejected.
  • Claims with only a Medicare legacy number in the primary provider field will be rejected.

Optical dispensary and other Medicaere DMEPOS suppliers may also be experiencing claims rejections if they did not obtain their NPIs properly or if they are not properly enrolled in Medicare.

Recommendation: Test the NPI–only claims now. If you have been using both NPI and Medicare legacy numbers on claims to date and you have been receiving payment, test your ability to receive payment using only the NPI number. Submit a small sample of claims without the Medicare legacy number – use only the NPI. If the claims cannot be crosswalked to match the NPi, the claims will be rejected. This allows you time to address the problem prior to the March 1st deadline.

The January NPI message is available on the CMS Website at: http://www.cms.hhs.gov/NationalProvIdentStand/02_WhatsNew.asp

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