NPI Clarity for MA Patients 7/1/25- 6/30/26

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    • Type: Logic/Intent/Data Elements
    • Resolution: Unresolved
    • Priority: Moderate
    • None
    • Jenna Leigh Pickard
    • Medisolv
    • Not measure related
    • Not measure related

      Which NPI will be used for Medicare Advantage (MA) patients for 7/1/25-6/30/26?  Will it be the first provider they come in contact in the ED, the admitting provider, the inpatient provider, maybe their PCP?  We need some more guidance on how to know what NPI CMS will be expecting in the QRDA file. 

            Assignee:
            Rachelle Zribi
            Reporter:
            Jenna Leigh Pickard
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              Created:
              Updated: