Provider Notice issued 09/01/10

Reporting of the Prescriber's National Provider Identifier (NPI)

This is an important reminder that the prescribing practitioner's NPI must be reported on all prescriptions. The department requires pharmacies to report the prescriber's identification number on all pharmacy claims. Currently, the department will accept the prescriber's DEA number, state license number or legacy provider number in cases where the pharmacy does not have the prescriber's NPI number and has exhausted all options for obtaining the prescriber's NPI. However, effective September 15, 2010, the department will reject pharmacy claims that do not contain the prescriber's NPI. In order to ensure that pharmacies have the prescriber's NPI, the prescriber must report their NPI on the prescription. Patients may be inconvenienced and pharmacies will have to take extra action to obtain the NPI if the prescriber does not initially supply his/her NPI.

It is important that the prescriber record his or her own NPI on the prescription, and not the NPI of a group practice, hospital or other facility. If a patient tries to fill a prescription, and the pharmacy does not have the prescriber's NPI, the pharmacy will have to contact the prescribing practitioner's office in order to obtain the NPI prior to filling the prescription.

In addition, if a prescriber who practices at a hospital writes a prescription on a prescription pad that contains only the hospital's name and address, the prescribing practitioner must print their name legibly on the prescription pad, and include their NPI. Residents must also record their NPI on their prescriptions. Residents can obtain their own NPI. See Centers for Medicare and Medicaid Services (CMS) for guidance related to this topic. Search for question number 8479.

HFS encourages providers that have not yet obtained NPIs to do so immediately. To apply for an NPI, visit the National Plan/Providers Enumeration System (NPPES) Website.

If you have any questions regarding this notice, please contact the Bureau of Comprehensive Health Services toll-free at 1-877-782-5565.

Theresa A. Eagleson, Administrator

Division of Medical Program