Ensure Uninterrupted Cash Flow with NPI

Beginning May 23, Medicare will only accept and send National Provider Identifier (NPI)-only transactions.

The Centers for Medicare and Medicaid Services (CMS) reported that Medicare is receiving more than 98% of claims with an NPI. Still, CMS is concerned that the percentage of Medicare claims with NPI-only is not growing fast enough.

The next milestone requires providers to take the next step so they do not risk disruption in cash flow.

Steps to facilitate a smooth transition to NPI-only:

  1. Bill with Medicare legacy ID and NPI. Once claims are successfully processed, move to Step 2.
  2. Bill with NPI-only. Start with a small batch of claims. If, or when, the results are positive, begin sending a greater volume and move to Step 3.

    Billing with NPI-only also tests the ability to receive the NPI on 835 transactions.

  3. Test NPI-only on other HIPAA transactions. CMS will require use of the NPI on the 270/271, 276/277 and NCPDP transactions. Providers should begin testing the use of the NPI on these transactions, in small quantities, prior to May 23rd to ensure a smooth transition. Also, be prepared to accept the NPI-only on the 835 remittance advice transaction.

If you are unsure about the NPI, visit the CMS NPI page at www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at (800) 465-3203.

All current and past CMS NPI communications are available by clicking “CMS Communications” in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS Web page.

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