In late May, the Centers for Medicare and Medicaid Services (CMS) began the process of assigning a unique 10-digit identifier known as a National Provider Identifier (NPI) to health professionals and health-care entities who apply for one. From the outset, the APA Practice Organization has been seeking clarification about and refinements to the NPI process from CMS.
The federal agency requires anyone subject to the 1996 Health Insurance Portability and Accountability Act (HIPAA) to apply for an NPI number by May 23, 2007. The identifiers, which are associated with a provider's type of practice and contact information, are intended for use in identifying practitioners when they transmit health information electronically--for example, claims for payment and referral authorizations. Health-care professionals will be assigned an NPI once they successfully complete the NPI enrollment process.
In applying for an NPI, providers need to pick a "taxonomy code," or codes corresponding to various health-care practice descriptions. It was not entirely clear initially how the taxonomy codes related to the NPI would be used and whether there would be an opportunity for groups like the APA Practice Organization to have input about these codes.
According to Billie Hinnefeld, senior director for legal and regulatory affairs for the Practice Organization, CMS has explained that the purpose of these codes is to help distinguish between health professionals--for example, Mary Smith the psychologist versus Mary Smith the oncologist.
"We have been assured that the taxonomy codes are just for identification and will not be used by federal health-care programs to limit the kinds of services a practitioner can provide or bill for," says Hinnefeld, adding that CMS has indicated that psychologists will be able to select up to 15 taxonomy codes, if necessary, to describe their practices.
As initially listed, the taxonomy codes include two main categories for psychologists: psychology and neuropsychology. Within the broader categories, there are codes for subcategories, such as addiction, child, youth and family, and forensic psychology.
The taxonomy codes are not yet complete, Hinnefeld says. In addition to submitting comments and suggestions about the current taxonomy codes, she notes, the Practice Organization also is making suggestions for new categories of codes.
Based on communications with CMS staff, Hinnefeld expects that the codes will be updated and clarified by mid-2006. She says APA members who intend to enroll for an NPI may wish to wait until this happens, since they still would have ample time before the May 2007 enrollment deadline. The Practice Organization plans to apprise APA of developments as psychology gains additional clarification and updates about the codes.
The codes that have been identified so far are available at www.wpc-edi.com/codes/taxonomy.
The form for enrolling in the program--CMS No. 10114--is located at www.cms.hhs.gov/forms.