Health Information Management

CMS provides NPI guidance for Medicare DME suppliers

HIPAA Weekly Advisor, August 14, 2006

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CMS will link Medicare provider numbers with NPIs and require Medicare durable medical equipment (DME) suppliers to obtain an NPI for each location, according to the agency.

The only exceptions to the requirement are situations in which a Medicare DME supplier is a sole proprietor. A sole proprietor is eligible for only one NPI, regardless of the number of locations the supplier has.

This location requirement also applies to those Medicare DME suppliers who do not send electronic claims to Medicare. Federal regulations require the unique enumeration of every location of a Medicare DME supplier, regardless of how they submit claims. According to CMS, failure to comply may result in delayed processing or rejection of claims.

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