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Services (CMS) Transmittal 29 Date: OCTOBER 12, 2007 Change Request 5490 Note: Transmittal 25, dated April 20, 2007, is rescinded and replaced with transmittal 29.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.

2 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. 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).

3 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.

4 However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. 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.

5 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. 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.

6 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).

7 The CCN continues to serve a critical role in verifying that a provider has been Medicare certified and for what type of services. 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.)

8 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.

9 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. B. Medicare Administrative Contractors: The contractor is hereby advised that this constitutes technical direction as defined in your contract.

10 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.)