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Reminder: Use NPI on Medi-Cal and CHDP Claims

June 24, 2010

Providers are reminded that the Department of Health Care Services (DHCS) will only accept the National Provider Identifier (NPI) on all Medi-Cal and Child Health and Disability Prevention (CHDP) program claims. This policy has been in effect since October 1, 2008.

To insure timely payment, pharmacies using the Medi-Cal POS NCPDP Pharmacy Transaction Specifications, Third Party Vendors (Dial-Up and Leased-Line) system must include the NPI of any practitioners prescribing drugs for Medi-Cal recipients. Claims submitted with incorrect or invalid NPIs may cause a delay in payments and an audit of all claims submitted by the pharmacy.

For additional questions regarding NPI or its use in claims billing, providers can review the NPI Overview page, or call the Telephone Service Center (TSC) at 1-800-541-5555.



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