MedicaidAdministrativeHigh impact
[Ohio] National Provider Identifier (NPI) for Ordering, Referring and Prescribing (ORP) Providers
CareSource·OH·Provider Bulletin
Effective date
Jul 1, 2025
We identified it
May 9, 2026
Summary
Effective July 1, 2025, CareSource Ohio Medicaid and MyCare plans require providers to submit the National Provider Identifier (NPI) number for any Ordering, Referring, or Prescribing (ORP) provider on all claims. Claims submitted without this information will be rejected with a 277 rejection code.
Action Required
By July 1, 2025: Billing team must update all claim submission processes to require and validate the ORP provider's NPI number on every claim submitted to CareSource Ohio Medicaid and MyCare plans. Update billing software system rules to mandate NPI capture for ordering, referring, and prescribing providers on encounter forms and claim templates. Configure system to flag claims missing ORP NPI for rejection prevention. Train all billing and clinical staff on the requirement. Failure to include ORP provider NPI will result in automatic 277 claim rejections and delayed reimbursement.