Health Care Provider Unique Identification Per Site Or Service

Health care providers - claims for payment for services - use of unique provider identifier. The act requires an off-campus location of a hospital to apply for, obtain, and use on claims for reimbursement submitted on or after January 1, 2020, for health care services provided at the off-campus location a unique national provider identifier, commonly referred to as "NPI". The off-campus location's NPI must be used on all claims related to health care services provided at that location, regardless of whether the claim is filed through the hospital's central billing or claims department or through a health care clearinghouse.

Additionally, all medicaid providers that are entities are required to obtain and use, on and after January 1, 2020, a unique NPI for each site at which they deliver services and for each provider type that the department of health care policy and financing has specified. Entity medicaid providers must use on all claims the unique NPI that identifies both the site where the services were provided and the provider type rendering the services, regardless of whether the claim is filed through the entity's central billing or claims department or through a health care clearinghouse.

(Note: This summary applies to this bill as enacted.)