Palmetto GBA: Providers Must Use Individual NPIs to Bill for Ordered/Referred Services

Palmetto GBA will be contacting home health agencies that submitted claims using both a group name and national provider identifier (NPI) as the attending NPI for ordered or referred services.

The physician’s name and NPI, not a group name and NPI, must be used as the attending name and NPI on the claim. Once CMS turns on the edits for ordering/referring services, claims using a group NPI will be denied.

CMS recently sent a message to remind physicians to provide their individual NPI to home health agencies upon request. Physicians may verify their individual NPI using the NPI Registry on the CMS website.

Tags:


%d bloggers like this: