MedicaidAdministrativeHigh impact
HIPAA-Compliant Data, Including National Provider Identifiers, Required for All Fields on Claims
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
We identified it
Jun 20, 2026
Summary
All claim fields must now contain HIPAA-compliant data including valid CPT and HCPCS codes in optional fields. National Provider Identifiers (NPIs) are now required for all provider fields - Medicaid provider numbers and UPINs will no longer be accepted.
Action Required
Immediately: Billing team must update all claim forms and electronic submissions to use NPIs in all provider fields (rendering, billing, referring, attending). Remove all Medicaid provider numbers and UPINs from billing system. Ensure all optional fields contain valid HIPAA-compliant CPT/HCPCS codes or leave blank. Claims will be denied if non-compliant data is submitted.