Provider & Assignment Details
In these slides, you’ll learn how to document the rendering provider’s NPI and indicate Medicare assignment acceptance.
Loop 2310B NM109 or 2420A NM109 / Item 24J
| Rendering Provider ID Number | Source |
|---|---|
Enter the rendering provider’s NPI number in the lower unshaded part. For services provided incident to the service of a physician or non-physician practitioner, when the ordering person isn’t supervising, enter the supervisor’s NPI in the lower unshaded part. This instruction doesn’t apply to flu and pneumonia shot claims submitted on roster bills because they don’t require a rendering provider NPI. Don’t report the shaded part. | NPPES offers a searchable NPI Registry. You also can get the NPI from the ordering or referring health care professional. |
Loop 2300 CLM07 / Item 27
| Accept Assignment? | Source |
|---|---|
| Check the appropriate block to indicate whether the provider of service or supplier accepts assignment of Medicare benefits. | Health care professional or supplier’s records |
If item 9 (Other Insured’s Name) shows Medigap and Medigap payment authorization is in item 13, the health care professional or supplier providing the service is also a Medicare participating provider of service or supplier and must accept assignment of Medicare benefits for all covered charges for all patients.
More Information on Assignment
Medicare pays claims for the following health care professionals or suppliers only on an assigned basis:
- Ambulance services
- Ambulatory Surgical Center (ASC) services for covered ASC procedures
- Clinical diagnostic laboratory services
- Drugs and biologicals
- Participating physician, health care professional, and supplier services
- Physician services to people dually entitled to Medicare and Medicaid
- Services of physician assistants (PAs), certified registered nurse anesthetists (CRNAs), clinical psychologists (CPs), clinical social workers (CSWs), clinical nurse specialists (CNSs), nurse-midwives, and nurse practitioners (NPs)
- Simplified billing roster for flu, pneumococcal, and COVID shots