222 South College, 2nd Floor, Springfield, IL 62704

PROVIDER INFORMATIONAL NOTICE
TO: Early Intervention Providers
FROM : Janet D. Gully, Chief
Bureau of Early Intervention
DATE: February 20, 2007
SUBJECT: National Provider Identifier (NPI) -Business Practices for Processing Early

Intervention Claims

Beginning with claims submitted on or after May 23, 2007, Early Intervention will require that both individual and agency payees submit the NPI of the individual that actually provided the service, or that person’s supervisor if that person is an associate level provider, on all electronic, direct data entry, and hard copy claims. The exceptions are for parent liaison, deaf mentor, interpreter, and transportation services. Claims submitted on or after May 23, 2007 without NPI’s will be denied.

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Prior to the May 23 mandatory requirement of submitting NPIs, payees and providers must report their NPI to the Department of Healthcare & Family Services (HFS). To review the HFS Information Notice to providers concerning the NPI, please go to the HFS website at http://www.hfs.illinois.gov/all/. The Web-based application for reporting an NPI to HFS can be found at http://www.illinoisnpi.com.

Information on the NPI, including how to apply, can be found at the Centers for Medicare and Medicaid Services (CMS) at http://www.cms.hhs.gov/NationalProvidentStand/. A web-based application process can be found at https://nppes.cms.hhs.gov. The taxonomy code set can be found at www.wpc-edi.com.

If you have questions concerning this notice, please call the Early Intervention Central Billing Office Call Center at 800/634-8540. Thank you for your prompt attention to this matter.

For Your Information: When applying for an NPI, providers are required to submit a taxonomy code. This is a code that identifies the provider type such as physical therapy, etc. A new taxonomy code, Developmental Therapist, has been created by the Code Committee of the National Uniform Claim Committee. The new code was included in the January 1, 2007 release of changes to the taxonomy code set, but will not go into effect until April 1, 2007. The code will be found in the code set under Respiratory, Developmental, Rehabilitative and Restorative Service Providers.