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MLN Matters Article (New) MM12889: New Fiscal Intermediary Shared System Edit to Validate Attending Provider NPI

This new Article comprises Subregulatory Guidance for a new consistency edit that validates the attending provider NPI and that organizational NPIs can’t be used in place of individual NPIs, unless exception conditions are met. MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR12889 that is posted on the CMS website at https://www.cms.gov/files/document/r11633CP.pdf.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 06, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.