PA,NP, CNS, CNM Billing Guide, REF-EDO-0020 - NHIC, Corp.
PA,NP, CNS, CNM Billing Guide, REF-EDO-0020 - NHIC, Corp.
PA,NP, CNS, CNM Billing Guide, REF-EDO-0020 - NHIC, Corp.
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Physician Assistant (<strong>PA</strong>), Nurse Practitioner (<strong>NP</strong>), Clinical Nurse Specialist (<strong>CNS</strong>),<br />
and Certified Nurse-Midwife (<strong>CNM</strong>) <strong>Billing</strong> <strong>Guide</strong><br />
_______________________________________________________________________<br />
National Provider Identifier (<strong>NP</strong>I)<br />
Physician Assistant<br />
Payment of <strong>PA</strong> services is made only to the <strong>PA</strong>’s employer. If the employer is a group practice,<br />
the group must include their group <strong>NP</strong>I in Item 33a, including name and address and list the<br />
individual <strong>PA</strong>’s <strong>NP</strong>I in Item 24J on the CMS 1500 claim form or electronic equivalent.<br />
If the employer is a sole proprietor, he/she must include his/her individual <strong>NP</strong>I in Item 33a,<br />
including the name and address and list the individual <strong>PA</strong>’s provider number in 24J on the CMS<br />
1500 claim form or electronic equivalent.<br />
Nurse Practitioner, Clinical Nurse Specialist, and Certified Nurse-Midwife<br />
<strong>NP</strong>s, <strong>CNS</strong>s, and <strong>CNM</strong>s can bill the Medicare program directly for their services or reassign<br />
payments to an employer. When <strong>NP</strong>s, <strong>CNS</strong>s, and <strong>CNM</strong>s are rendering services and wish to<br />
receive payment directly, the <strong>NP</strong>I of the <strong>NP</strong>, <strong>CNS</strong>, or <strong>CNM</strong> must be entered in Item 33a,<br />
including the name and address, on the CMS 1500 claim form or electronic equivalent.<br />
If the employer is a group practice, the group must include their group <strong>NP</strong>I in Item 33a,<br />
including name and address and list the individual <strong>NP</strong>, <strong>CNS</strong>, or <strong>CNM</strong> number in Item 24J on the<br />
CMS 1500 claim form or electronic equivalent.<br />
If the employer is a sole proprietor, he/she must include his/her individual <strong>NP</strong>I in Item 33a,<br />
including the name and address and list the individual <strong>NP</strong>, <strong>CNS</strong>, or <strong>CNM</strong> <strong>NP</strong>I in 24J on the CMS<br />
1500 claim form or electronic equivalent.<br />
<strong>NHIC</strong>, <strong>Corp</strong>. 22 July 2010<br />
<strong>REF</strong>-<strong>EDO</strong>-<strong>0020</strong> Version 1..0<br />
The controlled version of this document resides on the <strong>NHIC</strong> Quality Portal (SharePoint). Any other version or copy, either electronic<br />
or paper, is uncontrolled and must be destroyed when it has served its purpose.
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