National Provider Identifier (NPI) for a Service Facility

Home Provider Part B Publications 2007 Archives

Does the "requirement" to indicate the service facility's NPI on your Medicare claim submissions confuse you? You are not alone.

Claim form instructions in the Centers for Medicare & Medicaid Services' (CMS) Internet-Only Manual (IOM), Publication 100-04, Chapter 26, Section 10.4 states the following for item 32A:

Item 32A Form CMS-1500 (08-05) - Enter the NPI of the service facility as soon as it is available. The NPI may be reported on the Form CMS-1500 (08-05) as early as January 1, 2007, and must be reported May 23, 2007, and later.

CMS defines a service facility as a hospital, clinic, laboratory, or facility other than the patient's home or physician's office.

CMS recently clarified that although you are not required to submit a service facility NPI in item 32A, it must be an NPI if you choose to enter a service facility identifier on any form CMS-1500 submitted on or after May 23, 2007.

You can view CMS Publication 100-04 at the following CMS Website address:
http://www.cms.hhs.gov/manuals/downloads/clm104c26.pdf adobe portable format document

Page Last Updated: Tuesday, 15-Jul-2008 10:45:23 CDT