MedicaidAdministrativeHigh impact
Revisions to Billing Requirements for Reporting the Attending and Other Provider NPIs
Illinois Medicaid - HFS·IL · Nephrology·Provider Notice
Effective date
Aug 1, 2011
We identified it
Jun 21, 2026
Summary
Illinois Medicaid now requires attending provider NPIs on ALL claims including outpatient renal dialysis, and mandates specific qualifier codes with NPIs in form locators 78-79. Claims missing required NPIs or qualifier codes will be rejected with new error codes.
Action Required
By August 1, 2011: Billing team must update all claim submission processes to include attending provider NPIs in form locator 76 for ALL claims (including outpatient renal dialysis). For form locators 78-79, ensure proper two-digit Provider Type Qualifier Codes accompany all NPIs. Update billing software to validate qualifier codes (ZZ for Other Operating Physician, 82 for Rendering Provider, DN for Referring Provider) to prevent claim rejections with new error codes G33, H45, H55, H56.