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Use NPI in Secondary Provider Fields

December 7, 2010

Providers are strongly encouraged to use a valid NPI (National Provider Identifier) in secondary provider fields. This includes fields such as Rendering Provider, Referring Provider, Attending Provider, Admitting Provider and Operating Provider, where applicable. A valid NPI of the inpatient facility where services were rendered is also required in the Service Facility field.

A valid NPI is required in the Referring Provider field when available. If an NPI for the referring provider is not available, a valid license number may be used.

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health Care Services (DHCS) strongly encourage providers to share their NPI with every entity they work with, such as payers and other providers that may need their NPI for billing purposes. Providers are encouraged to perform the necessary updates to their system and/or billing procedures to include the NPI in the secondary provider fields.

Additional information will be made available to providers in upcoming Medi-Cal Updates and on the Medi-Cal website. The Telephone Service Center (TSC) can also answer questions for providers at 1-800-541-5555 from 8 a.m. to 5 p.m., Monday through Friday.