The NPI is here. The NPI is now. Are you using it?

From: Haugen, Valerie A. (CMS/CMM)
Sent: Monday, April 28, 2008 3:34 PM
Subject: NPI Information for Medicare FFS Providers: May 7th is "Legacy Free" Day!


The NPI is here.  The NPI is now.  Are you using it?

 Important Information for Medicare FFS Providers


May 7 is “Legacy Free” Day – An opportunity to check your NPI readiness!

 CMS, in collaboration with the Healthcare Information and Management Systems Society (HIMSS), has requested clearinghouses that submit claims to FFS Medicare to participate in a one day NPI preparation exercise.  Specifically, on Wednesday, May 7, 2008, participating clearinghouses should submit Medicare claims with NPI-only in all provider identifier fields for which a provider uses NPI/legacy pairs.  On May 8th, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs as received from the providers. 


Through its monthly NPI messages, CMS has been requesting providers to begin testing NPI-only by sending a group of claims with NPI alone in primary provider fields.  This “exercise” will result in feedback from your Medicare contractor on your readiness as it pertains to your National Provider Identifiers. 


On May 7, 2008, participating clearinghouses will send Medicare claims with NPI-only in provider fields which originally contain NPI/legacy pairs from the provider.  In other words, clearinghouses will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair.  Of course, fields already containing NPI-only will be sent to Medicare, as usual, and secondary provider identifier fields containing legacy-only will be sent to Medicare, as usual.


This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008 deadline.


The outcomes of this exercise are described below:

  • Claims are processed and paid by Medicare.  Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23rd implementation date.


  • Claims are rejected or suspended.  Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23rd.  Resolution might include changes to the NPESS data or to the 855 enrollment record.

Again, on May 8, 2008, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs, if sent to them by the provider.


Participating clearinghouses will be soon notifying provider clients about details so pay close attention to Clearinghouse communications.



Need More Information?

Still not sure what an NPI is and how you can get it, share it and use it?  As always, more information and education on the NPI can be found through the CMS NPI page on the CMS website.  Providers can apply for an NPI online at or can call the NPI enumerator to request a paper application at 1-800-465-3203.  Having trouble viewing any of the URLs in this message?  If so, try to cut and paste any URL in this message into your web browser to view the intended information. 


Note: All current and past CMS NPI communications are available by clicking " CMS Communications" in the left column of the CMS webpage.




Valerie A. Haugen, Director
Division of Provider Information Planning & Development
Provider Communications Group, CMS
(410) 786-6690

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