New provider number intended to simplify electronic transactions

Sunday, May 29, 2005

BALTIMORE -- CMS last week began accepting applications for the new National Provider Identifier, which will replace healthcare provider numbers currently used for standard healthcare transactions.

CMS created the NPI, a requirement of the Health Insurance Portability and Accountability Act of 1996, to help improve electronic transactions for health care. The 10-digit number will replace the different identifiers providers currently use for each health plan they do business with.

According to CMS: "Each physical location of a supplier of DME, orthotics, prosthetics, or supplies will be considered a health care provider in its own right and must apply for and will be assigned an NPI."

The transition for existing numbers to the NPI will occur over the next few years. All HIPAA-covered health plans must implement the NPI by May 23, 2007. Small health plans have until May 23, 2008.

CMS began accepting NPI applications on May 23. Providers, however, should not use the NPI for transactions until after the compliance dates or until a particular health plan specifies that they are ready to accept them.