MedicaidAdministrativeHigh impact
Newsletter Vol. 16, No. 18
New Jersey Medicaid·NJ·Provider Notice
Effective date
May 23, 2007
We identified it
Jun 20, 2026
Summary
All NJ FamilyCare/Medicaid covered entities (healthcare providers, health plans, clearinghouses) must obtain and report a valid National Provider Identifier (NPI) on all claims submitted on or after May 23, 2007. Claims submitted without a valid NPI will be denied. Providers must apply for an NPI through CMS and notify the NJFC/Medicaid program of their assigned NPI.
Action Required
By May 23, 2007: (1) All billing team members and providers eligible for NPI must apply for a National Provider Identifier through CMS at https://nppes.cms.hms.gov or by paper application (contact 1-800-465-3203). (2) Billing team must obtain the assigned NPI from the NPI Enumerator and provide it to all software vendors and billing agents. (3) Update all billing systems and claim submission processes to include the NPI in addition to or replacing the previous provider number on all NJFC/Medicaid claims. (4) Billing team must report the NPI to the State of New Jersey via http://www.njmmis.com (available as of February 1, 2007). (5) For electronic HIPAA 837 claims, begin reporting NPI immediately upon receipt; for paper claims, implement by the effective date. Failure to report a valid NPI will result in automatic claim denial by NJFC/Medicaid effective May 23, 2007.