National Provider Identifier

 

Frequently Asked Questions about the

National Provider Identifier (NPI)

 

1. Who needs a National Provider Identifier (NPI)?

All LCSWs who work with public or private insurance companies need a National Provider Identifier (NPI) number.  The NPI is a unique number that identifies every provider for Medicare and/or in other insurance plans.

2. When did the NPI system start?

The NPI system began on May 23, 2007, and was first required for Medicare providers only. Virtually all other public and private insurers now require an NPI number for reimbursement.

3. How can I get an NPI?

You can apply for an NPI at: www.cms.hhs.gov/NationalProvidentStand. For alternative methods of applying go to www.cms.gov/NationalProvidentStand/03_apply.asp#TopOfPage.

 

4. What is the taxonomy code for clinical social workers, which is required to get an NPI?

The taxonomy code is 1041C0700X.

5. Where does the NPI belong on the CMS-1500?

Your NPI number should only be used in box 33a and 24j. DO NOT include your NPI anywhere else or claims may be rejected. LCSWs are encouraged to talk with their Medicare intermediary if they experience problems with their claims.

6. Where can I find more information on CMS-1500 forms?

For more information on how to fill out the CMS-1500 forms, go to:
http://www.medical-coding.net/claimforms/claim_form_manual_v1-3_7-06.pdf .

7. Where can I get CMS-1500 forms?

Most stores and websites which sold the HCFA-1500 are now selling the CMS-1500. There are also several websites which offer electronic versions of the CMS-1500 for those who file electronically. They can be accessed by a web search of "CMS-1500."

8. Do I need to use an NPI if I am an out-of-network provider?

Virtually all insurers now require the NPI as the clinician identifier for reimbursement as an in-network or out-of-network provider.

 

More questions? Contact Laura Groshong, CSWA Director of Government Relations, at lwgroshong@clinicalsocialworkassociation.org.

 

©CSWA2011

 

 

 

 

Legislative Alerts

  • 04/02/2014 - 5:33pm
    None

    HR 4302 passed the Senate this evening and is very likely to be signed by the President shortly.