Medicare Claims Require NPI

As of March 1, Medicare fee-for-service claims must include an national provider identifier (NPI) in the primary provider fields on the claim (billing, pay-to provider, and rendering provider fields). Claims will be rejected without it.

You may continue to submit NPI/legacy pairs in these fields or submit only your NPI. The secondary provider fields (referring, ordering, and supervising) may continue to include only your legacy number, if you choose.

In addition, if you already bill using the NPI/legacy pair in the primary provider fields and your claims are processing correctly, now is a good time to submit to TrailBlazer Health Enterprises a small number of claims containing only the NPI in the primary provider fields. This test will serve to ensure your claims will successfully process when the NPI only is mandated on all claims.

Action , March 3, 2008

Last Updated On

June 14, 2010

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