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05/07/2008
NPI Mandatory for Medicare
Effective May 23, 2008, all Medicare providers will be required to use ONLY their NPI number when filing Medicare claims. The reporting of Medicare legacy numbers after this date will result in claim denial. From now until May 23, 2008, providers are encouraged to test their ability to get paid using only their NPI number. Centers for Medicare and Medicaid Services (CMS) recommends sending one or two claims with ONLY the NPI number and if those claims are paid, to continue to increase the volume of NPI-only claims.
If your CMS-1500 claims are rejected, you may first wish to visit the National Plan and Provider Enumerator System (NPPES) website to make sure all of the information for your NPI is accurate. If claims continue to be rejected, have a copy of your NPPES record in hand (available on the NPPES website) and contact your Medicare Contractor.
When submitting claims, make sure that you pair your individual legacy number with your individual NPI number and that claims submitted using your group Medicare number are paired with your group NPI.
For more information, visit the CMS website by clicking here.
