NPIs Viewed as Key to MTM Reimbursement

Ken Rankin
Published Online: Friday, July 1, 2005

Pharmacy leaders are urging all pharmacists to obtain National Provider Identifiers (NPIs) from the government, predicting that the new ID code could be one of the keys for securing compensation for Medication Therapy Management (MTM) services next year.

The NPI is a standard unique identifier that can be used to identify the pharmacist, physician, or other health care provider in transactions with federal and state programs such as Medicare and Medicaid and in claim transactions with other third-party payers.

Pharmacists who electronically transmit any health information between 2 parties to carry out financial or administrative activities related to health care will be required to obtain an NPI. According to the American Pharmacists Association, however, even pharmacists who are not required to obtain an identifier should do so because "the NPI could become the provider identifier for pharmacists providing MTM services"under the new Medicare Part D prescription drug benefit that takes effect on January 1, 2006.

Pharmacists may apply for an NPI on-line at https://nppes.cms.hhs.gov. A paper application can be obtained by calling 800-465-3203.

Mr. Rankin is a freelance medical writer.



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