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IL 2020-38 Institutional Claim, Attending Provider’s NPI for ICF/IID Program Providers

Last updated on 8/13/2020

Effective August 31, 2020, the Texas Health and Human Services Commission (HHSC) will implement changes to Long-Term Care Institutional Claims.

HHSC will add an Institutional Claim-Provider Tab and insert edits to the Institutional Claim-Details Tab in the Texas Medicaid & Healthcare Partnership (TMHP) claim submission portal TexMedConnect and claims management system.

Changes will include edits to ensure Attending Provider national provider identifier (NPI) does not match the Billing Provider NPI. Additionally, Attending Provider must be a person. Should a facility not have a physician or nurse practitioner on staff whose information can be entered, it is allowable for the facility use the name and NPI of the resident’s primary care physician.

Read more in IL 2020-38 Institutional Claim, Attending Provider’s NPI (PDF).