MedicaidAdministrativeHigh impact
Referring and Ordering Practitioner NPI – Delayed Implementation
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 1, 2008
We identified it
Jun 21, 2026
Summary
Starting October 1, 2008, all claims with referring or ordering practitioner names must include the practitioner's NPI number. Claims submitted without the required NPI will be rejected by Illinois Medicaid.
Action Required
By October 1, 2008: Billing team must update all claim submission processes to include NPI numbers for referring and ordering practitioners. Update paper claim forms (HFS 1443, 2360, 2210, 2211, 2212, 3797), Direct Data Entry system, and electronic 837P/837I formats to capture and report practitioner NPIs in specified fields. Verify billing software populates NPI data correctly. Claims will be rejected without proper NPI reporting.