2018-24: NPI Required for Unlicensed Mental Health Rehabilitation Providers Beginning August 1, 2018

Date: 04/17/18

Effective August 1, 2018, unlicensed roster staff rendering Mental Health Rehabilitation (MHR) services through an agency must bill with their individual NPI number in box 24Jb on the CMS-1500 (HCFA).

This requirement will bring unlicensed MHR providers into alignment with other healthcare providers, in accordance with the Billing and Claims Submission section of the Louisiana Health Care Connections Provider Manual and 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers. 

Beginning August 1, 2018, claims submitted without an individual NPI will be denied. 

Use Taxonomy Code 171M00000X

Louisiana Healthcare Connections has worked with the Office of Behavioral Health on this requirement. Non-licensed behavioral health staff must be registered with a taxonomy code of 171M00000X. Non-licensed staff who already have an NPI number will need to change their current taxonomy to 171M00000X.

Submit Updated Rosters by June 1

Agencies employing unlicensed MHR providers must submit updated rosters including NPI numbers for their unlicensed providers. This information should be included in the monthly roster update to Louisiana Healthcare Connections. We recommend submitting updated roster information, including unlicensed MHR provider NPI numbers, by June 1, 2018 in order to be ready for the August 1, 2018 NPI requirement. 

The behavioral health facility roster template can be downloaded here. Updated rosters should be emailed to LHC_PROVIDER_CREDENT@CENTENE.COM.

Resources to Help

To assist in this process, we have compiled FAQS and helpful tips on getting a free National Provider Identification number from CMS.