Important Message Regarding CMS Educational Products

As of April 2, 2007, covered entities (including health plans, covered health care providers and clearinghouses) have the ability to adopt contingency plans for NPI implementation.  For example, Medicare's Fee-For-Service contingency plan allows for analysis of the claims volume submitted with NPIs and may begin rejecting claims that do not include an NPI for billing, pay-to and rendering providers as early as July 1, 2007.  For more details on the overall contingency guidance for the industry, as well as Medicare's Fee-For-Service contingency plan, click on the NPI Contingency Planning page in the column to the left side of this page. 

Guidance on NPI Disclosures by Industry Entities to Industry Entities

CMS has received numerous inquiries from health plans and other health care industry entities who want to create directories and listings containing health care providers' NPIs.  These entities feel it is necessary to create their own, enabling users of the directories to locate NPIs that they may need in order to create HIPAA-compliant transactions.  CMS has developed guidance on this issue; you can view the document entitled "NPI Disclosures by Industry Entities to Industry Entities" in the Downloads Section below. 

Transcript for 9/26/06 NPI Roundtable Now Available

The complete transcript for the 9/26/06 NPI Roundtable is now available – see "NPI Roundtable Transcript 9-26-06" under the Related Links Within CMS section below to view this document.

NPI Training Package

CMS has developed a Training package for NPI that will assist providers with self-education, as well as education of staff. This package is also useful to national and local medical societies for group presentations and training. The entire package consists of five modules: General Information, Electronic File Interchange (EFI), Subparts, Data Dissemination and Medicare Implementation. Each Module consists of a PowerPoint presentation (some with speaker's notes) and is designed to stand alone or can be combined with other Modules for a training session tailored to the particular audience.

Modules Currently Available (See "NPI Training Package" in the Downloads section below):

• Module 1: General Information
• Module 2: Electronic File Interchange (EFI)
• Module 3: Subparts
• Module 4: Data Dissemination
• Module 5: Medicare Implementation

Special CMS Communication Regarding the NPI and Medicare DME Suppliers: This communication addresses important information for Medicare DME suppliers.  (See the Downloads section below.)

NPI MLN Matters Articles

See the Downloads section below to view a compilation of MLN Matters articles pertaining to various aspects of the NPI.

NPI Frequently Asked Questions

NPI FAQs are posted on the CMS website and continue to be updated as new information is available.  To view these FAQs, see the "Related Links Inside CMS" section below.  To find the latest FAQs, click on the arrows next to "Date Updated".

NPI Fact Sheets

See the Downloads section below to view these Fact Sheets:

• General Information
• NPI Fact Sheet for Health Care Providers Who Are Individuals
• Subparts  
• Electronic File Interchange (EFI)
• NPI Fact Sheet for Health Care Providers Who are Sole Proprietors
• NPI Fact Sheet for Health Care Providers Who are Organizations

NPI Tip Sheets

See the Downloads section below to view these Tip Sheets:

• What the "Guidance on Compliance with the HIPAA National Provider Identifier (NPI) Rule" Means for Health Care Providers
• Tips for Health Care Professionals - Preparing Your Office Staff for NPI
• Guidance for Organization Health Care Providers Who Apply for National Provider Identifiers (NPIs) for Their Health Care Provider Employees

NPI PowerPoint Presentations

See the Downloads section below to view these PowerPoint Presentations

• NPI Overview
• Subparts

The Who, What, When, Why & How of NPI: Information for Health Care Providers - This educational flyer (See Related Links Inside CMS below) is designed to provide basic NPI information to providers who are enrolling in the Medicare program. As of May 1, 2006 health care providers are required to have an NPI prior to enrolling, or making an enrollment change, in the Medicare program.

The Workgroup for Electronic Data Interchange

The Workgroup for Electronic Data interchange (WEDI) was named in the HIPAA legislation as an organization with whom the Secretary must consult when developing any of the HIPAA Administrative Simplification (AS) standards. WEDI has published several NPI White Papers, conducts educational forums and audiocasts and hosts conferences. All this NPI information and educational is accessible through its website. See Links Outside CMS for a link to WEDI's website.  

NPI Question Resource Sheet

Many NPI questions that providers and their staff may have can be answered by the resources provided here on the CMS NPI page. The "NPI Question Resource Sheet" points to specific resources that can help answer common questions (see Downloads below).

Please note that CMS cannot respond individually to every question submitted as feedback via the website.  However, be assured that we are reviewing all questions to determine if new educational products or "Frequently Asked Questions (FAQs)" are needed or if revisions to existing products or FAQs are warranted. 

Downloads
Reporting a National Provider Identifier (NPI) and the "EY" Modifier on Claims for Durable Medical Equipment, Prosthetic, and Orthotic Supplies (DMEPOS) Items Dispensed without a Physician's Order to Obtain a Medicare Denial for Coordination of Benefits (COB) [PDF, 74KB] Guidance on NPI Disclosures by Industry Entities to Industry Entities [PDF, 59KB] NPI Training Package [PDF, 19KB] - Updated 08/30/07 Special CMS Communication Regarding the NPI and Medicare DME Suppliers [PDF, 16KB] NPI Related MLN Matters Articles [PDF 112KB] - Updated 02/25/08 NPI Fact Sheets [PDF, 25KB] NPI Tip Sheets [PDF 25KB] NPI PowerPoint Presentations [PDF, 22 KB] NPI Question Resource Sheet [PDF, 32KB] NPI Roundtable Transcript 9-26-06 [PDF 85KB] The Who, What, When, Why & How of NPI [PDF 105KB]
Related Links Inside CMS
Frequently Asked Questions Apply Now - National Plan and Provider Enumeration System (NPPES)
Related Links Outside CMS
Workgroup for Electronic Data Interchange (WEDI) NPI Outreach Initiative

Page Last Modified: 01/05/2009 10:21:15 AM
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