NPI Notice: Use It Now

As of May 23, your National Provider Identifier (NPI) will be required on all Medicare transactions. Even if you have a small practice (fewer than 10 full-time employees) and are not required to be HIPAA compliant because you don't do electronic transactions or file electronic claims, you must still use the NPI on the claims you file.

Because the NPI will be the only acceptable identifier starting on May 23, your patients will receive coverage for consults or lab work you prescribe only if you use an NPI. This is true even if you've opted out of Medicare and do not accept other insurance. Further, pharmacies will need a prescriber's NPI for prescriptions written for Medicare and Medicaid beneficiaries, regardless of whether the treatment you provide is covered by these programs. Private insurers are also required under HIPAA to use NPIs rather than any previous identifiers they may have had, so if you do not use an NPI, patients with private insurance will encounter the same coverage problems.

If your practice is incorporated and you have not opted out of Medicare, you will need to get two NPIs, a Type 1 NPI for you as a provider and a Type 2 NPI for your practice. If you do not take any insurance payments, you will need only a Type 1 NPI even if your business is incorporated because you will not be accepting any payments from entities that require an NPI.

The bottom line: If you haven't already gotten an NPI, do so before May 23. You can obtain an NPI online at<https://nppes.cms.hhs.gov/NPPES/Welcome.do> or get a paper application by calling (800) 465-3203. ▪