CMS Manual System

1 CMS Manual System Department of Health & Human Services (DHHS) Pub 100-07 State Operations Provider Certification Centers for Medicare & Medicaid Services (CMS) Transmittal 29 Date: OCTOBER 12, 2007 Change Request 5490 Note: Transmittal 25, dated April 20, 2007, is rescinded and replaced with transmittal 29. Information regarding the Transplant Centers new series 9800-9899 was incorrectly added. The new series will only be used by CMS. Also the Transplant Centers will bill on the hospital number; and therefore, the FIs do not need to make any changes for this. All other information remains the same. SUBJECT: New Number Series and State Codes for CMS Certification Numbers (formerly OSCAR Provider Numbers) I. SUMMARY OF CHANGES: The National Provider Identifier (NPI) will replace the Medicare/Medicaid Provider Number on Medicare claims. The NPI will assume the Medicare/Medicaid Provider Number's role as a primary identifier. However, the Medicare/Medicaid Provider Number will continue to be issued to providers and used to verify Medicare/Medicaid certification on all survey and certification, and resident/patient assessment transactions.

2 In order to avoid confusion with the NPI, the Medicare/Medicaid Provider Number (also known as the OSCAR Provider Number, Medicare Identification Number or Provider Number) has been renamed the CMS Certification Number (CCN). The CCN continues to serve a critical role in verifying that a provider has been Medicare certified and for what type of services. A new provider type entitled Transplant Centers has been identified, and a new CCN series has been assigned. New state codes have been assigned to the following states: California, Iowa, Minnesota. and Illinois New / Revised Material Effective Date: *October 1, 2007 Implementation Date: October 1, 2007 Disclaimer for Manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents.

3 II. CHANGES IN Manual INSTRUCTIONS: (N/A if Manual is not updated ) R=REVISED, N=NEW, D=DELETED-Only One Per Row. R/N/D Chapter / Section / Subsection / Title R 2/ table of Contents R 2/ 2779/ RO Assignment of CMS Certification Numbers III. FUNDING: No additional funding will be provided by CMS; Contractor activities are to be carried out within their FY 2007 operating budgets. IV. ATTACHMENTS: Business Requirements Manual Instruction *Unless otherwise specified, the effective date is the date of service. Attachment Business Requirements Pub. 100-07 Transmittal: 29 Date: October 12, 2007 Change Request: 5490 Note: Transmittal 25, dated April 20, 2007, is rescinded and replaced with transmittal 29. Information regarding the Transplant Centers new series 9800-9899 was incorrectly added. The new series will only be used by CMS. Also the Transplant Centers will bill on the hospital number; and therefore, the FIs do not need to make any changes for this.

4 All other information remains the same. SUBJECT: New State Codes for CMS Certification Numbers (formerly OSCAR Provider Numbers) Effective Date: October 1, 2007 Implementation Date: October 1, 2007 I. GENERAL INFORMATION A. Background: The National Provider Identifier (NPI) will replace the Medicare/Medicaid Provider Number on all Medicare claims. The NPI will assume the Medicare/Medicaid Provider Number s role as a primary identifier. However, the Medicare/Medicaid Provider Number will continue to be issued to providers and used to verify Medicare/Medicaid certification on all survey and certification, and resident/patient assessment transactions. In order to avoid confusion with the NPI, the Medicare/Medicaid Provider Number (also known as the OSCAR Number, Medicare Identification Number, or Provider Number ) has been renamed the CMS Certification Number (CCN). The CCN continues to serve a critical role in verifying that a provider has been Medicare certified and for what type of services.

5 This number is used throughout the various components of CMS, and maintaining this number is integral to CMS business operations. B. Policy: New state codes have been assigned to the following states: California, Iowa, and Minnesota. These new state codes are in addition to the state codes that already exist for these states. The new state codes are: 75 California; 76 Iowa; 77 Minnesota; and 78 Illinois. II. BUSINESS REQUIREMENTS table Use Shall" to denote a mandatory requirement Number Requirement Responsibility (place an X in each applicable column) Shared- System Maintainers A/B MACDME MACFI CARRIERDMERCRHHI FISS MCS VMS CWFOTHER The Medicare systems ( , Medicare claims processing systems, state systems, financial X X X X X X Number Requirement Responsibility (place an X in each applicable column) Shared- System Maintainers A/B MACDME MACFI CARRIERDMERCRHHI FISS MCS VMS CWFOTHER systems, etc.)

6 Shall make the necessary changes to accept the following new state codes as part of the CCN. The state codes are listed below: 75 California; 76 Iowa; 77 Minnesota; and 78 Illinois. III. PROVIDER EDUCATION table Number Requirement Responsibility (place an X in each applicable column) Shared- System Maintainers A/B MACDME MACFI CARRIERDMERCRHHI FISS MCS VMS CWFOTHER None IV. SUPPORTING INFORMATION A. For any recommendations and supporting information associated with listed requirements, use the box below: Use "Should" to denote a recommendation. X-Ref Requirement Number Recommendations or other supporting information: N/A B. For all other recommendations and supporting information, use the space below: V. CONTACTS Pre-Implementation Contact(s): Cheryl Hatcher Post-Implementation Contact(s): Cheryl Hatcher VI. FUNDING A. Title XVIII Contractors: No additional funding will be provided by CMS; contractor activities are to be carried out within their FY 2007 operating budgets.

7 B. Medicare Administrative Contractors: The contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the Statement of Work (SOW). The contractor is not obligated to incur costs in excess of the amounts specified in your contract unless and until specifically authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions regarding continued performance requirements. State Operations Manual Chapter 2 - The Certification Process table of Contents (Rev. 29, 10-12-07) 2779 - RO Assignment of CMS Certification Numbers 2779A - Numbering System for CMS Certification Numbers 2779A1 CMS Certification Numbers for Providers 2779A2 CMS Certification Numbers for Suppliers 2779B CMS Certification Numbers for Medicaid Providers 2779C - Special Numbering System for Units of Hospitals That Are Excluded From Prospective Payment System (PPS) and Hospitals with SNF Swing-Bed Designation 2779D - Assigning LTC CMS Certification Numbers 2779E - Assigning Emergency Hospital CMS Certification Numbers (Non-Participating Hospitals) 2779F - Merger of Facilities or CHOW 2779G - Notification of Change in CMS Certification Numbers 2779H - Retirement of CMS Certification Numbers 2779I - Control of CMS Certification Numbers 2779J - ESRD CMS Certification Numbers 2779K - HHA Branch CMS Certification Numbers 2779L Outpatient Physical Therapy (OPT)

8 Extension CMS Certification Numbers 2779 - RO Assignment of CMS Certification Numbers (Rev. 29, Issued: 04-20-07; Effective/Implementation Dates: 10-01-2007) 2779A - Numbering System for CMS Certification Numbers (Rev. 29, Issued: 04-20-07; Effective/Implementation Dates: 10-01-2007) The CMS Certification number (CCN) replaces the term Medicare Provider Number, Medicare Identification Number or OSCAR Number. The CCN is used to verify Medicare/Medicaid certification for survey and certification, assessment-related activities and communications. The RO assigns the CCN and maintains adequate controls. 2779A1 CMS Certification Numbers for Providers (Rev. 29, Issued: 04-20-07; Effective/Implementation Dates: 10-01-2007) The CCN for providers and suppliers paid under Part A have 6 digits. The first 2 digits identify the State in which the provider is located. The last 4 digits identify the type of facility.

9 Following is a list of all State Codes: Alabama 01 New Hampshire 30 Alaska 02 New Jersey 31 Arizona 03 New Mexico 32 Arkansas 04 New York 33 California 05, 55, 75 North Carolina 34 Colorado 06 North Dakota 35 Connecticut 07 Ohio 36, 72 Delaware 08 Oklahoma 37 District of Columbia 09 Oregon 38 Florida 10, 68, 69 Pennsylvania 39, 73 Georgia 11 Puerto Rico 40 Hawaii 12 Rhode Island 41 Idaho 13 South Carolina 42 Illinois 14, 78 South Dakota 43 Indiana 15 Tennessee 44 Iowa 16, 76 Texas 45, 67, 74 Kansas 17.

10 70 Utah 46 Kentucky 18 Vermont 47 Louisiana 19, 71 Virgin Islands 48 Maine 20 Virginia 49 Maryland 21, 80 Washington 50 Massachusetts 22 West Virginia 51 Michigan 23 Wisconsin 52 Minnesota 24, 77 Wyoming 53 Mississippi 25 Canada 56 Missouri 26 Mexico 59 Montana 27 American Samoa 64 Nebraska 28 Guam 65 Nevada 29 Commonwealth of the 66 Northern Marianas Islands Assign the last 4 digits sequentially from within the appropriate block of numbers.