CMS issues final rule on provider identification number

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Providers and suppliers who submit claims to Medicaid and Medicare must include an identification number on enrollment applications and payment claims, according to a final rule.

In a regulation that's effective June 26, the inclusion of a National Provider Identifier — which is a 10-digit provider identification number — will save Medicare $1.6 billion over 10 years, the Centers for Medicare & Medicaid Services estimates. The NIP, which also is required in HIPAA transactions, is used to verify certification as a means of curbing Medicare and Medicaid fraud and abuse.

While most providers already have an NPI, CMS said the savings estimate was calculated based on that a small number of patients would go to doctors without enrollment numbers, and therefore won't receive referrals for items like durable medical equipment.

The final rule will be published in the Federal Register on April 27. Click here to read the full rule.