by Ingrida Lusis
The federal National Provider Identifier (NPI) is the health care provider identification system adopted by the U.S. Department of Health and Human Services (HHS) as part of the implementation of the Health Insurance Portability and Accountability Act (HIPAA).
Although all health care providers that are considered covered entities under HIPAA-those who file claims electronically or use a clearinghouse to bill insurance-are required to apply for an NPI, any health care provider is eligible to apply for and receive an identification number. Audiologists and speech-language pathologists are encouraged to apply for the NPI.
How do I apply for an NPI?
Audiologists and SLPs can apply for an NPI in two ways:
1) visit the CMS Web site
2) mail an application to: NPT Enumerator, P.O. Box 6059, Fargo ND 58108-6059. Applications are available online [PDF].
Why should I obtain an NPI?
The NPI will eliminate the need for audiologists and SLPs to use different identification numbers when conducting business with multiple health plans. Many health plans, (including Medicare, Medicaid and private health insurance issuers) and all health care clearinghouses will be required to accept and use NPIs by May 23, 2007.
Will the NPI allow SLPs to bill Medicare directly?
No, the NPI cannot be used by a SLP to bill for Medicare Part B outpatient services. SLPs are encouraged to apply for an NPI in order to bill private health insurance and Medicaid. Legislation has been introduced that would recognize SLPs as suppliers under the Medicare program and allow them to utilize their NPI for billing for Medicare outpatient services. For more information visit ASHA's Take Action site.
Where can I find additional information on the use of the NPI?
Additional information on the NPI can be found on CMS's Medlearn page [PDF]. You can also contact ASHA at reimbursement@asha.org.
Ingrida Lusis is ASHA's director of health care regulatory advocacy. Contact her by e-mail at ilusis@asha.org or by phone at 800-498-2071, ext. 4482.