NPI
CareFirst requires that all claims submitted include your National Provider Identifier (NPI) so your practice can be identified. Your NPI must be registered with CareFirst and match the information on our Provider files.
Without your NPI and Tax Identification Number (TIN), your claims may be delayed or rejected.
Need an NPI?
You should apply through the National Plan and Provider Enumeration System (NPPES).
You can also obtain a copy of the paper NPI Application/Update Form (CMS-10114) by contacting the NPI Enumerator in one of three ways:
- Phone: (800) 465-3203 or TTY (800) 692-2326
- E-mail: customerservice@npienumerator.com
- Mail: NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059
Then, mail the completed, signed application to the NPI Enumerator located at the mailing address above.
If there are any changes or updates to your NPI information, please update CareFirst of these changes.
Payer Codes: CareFirst requires separate payer codes for professional and institutional claims. Please contact your clearinghouse to confirm the appropriate payer code.
Professional Claims Submission Requirements
| NPI Number | CMS-1500 | 837P |
|---|---|---|
| Rendering Provider NPI | Box 24J | 2310B Loop, NM109 |
| Billing Provider NPI | Box 33a | 2010AA Loop, NM109 |
| Referring Provider NPI | Box 17b | 2310A Loop, NM109 |
| Before you submit, make sure that both CareFirst and your billing partner have your current NPI information on file. | ||
Institutional Claims Submission Requirements
| NPI Number | UB-04 | 837I |
|---|---|---|
| Billing Provider NPI | FL56 | 2010AA Loop, NM109 |
| Attending Provider NPI | FL76 | 2310A Loop, NM109 |
| Operating Provider NPI | FL77 | 2310B Loop, NM109 |
| Before you submit, make sure that both CareFirst and your billing partner have your current NPI information on file. | ||
Other Resources
CareFirst is committed to providing you with the resources you need for a successful implementation to the National Provider Identifier. Below are links to some resources to assist you.
- Centers for Medicare and Medicaid NPI Education
- Workgroup for Electronic Data Interchange (WEDI) NPI Outreach Initiative
- National Uniform Claim Committee
- National Uniform Billing Committee
For questions specific to CareFirst, please send an email to NPI@carefirst.com.