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March 4 2025 Upcoming Supervising Provider Voids

March 4, 2025: Attention Professional Providers:  As a reminder of current policy in the Medicaid provider manual, claims to report either a nurse practitioner or physician assistant as the rendering provider is required to report a supervising physician.  

2.3.D. SUPERVISING PROVIDER The supervising physician NPI may be a professional claim editing requirement for physician services rendered by an enrolled non-physician practitioner, such as a physician’s assistant or advanced practice registered nurse. When physician collaboration or supervision is required by State law or Medicaid policy, claims must include the Medicaid-enrolled supervising physician NPI.  

 

20.4 NURSE PRACTITIONER BILLING AND REIMBURSEMENT Professional claims must include the NPI of the NP in the Rendering Provider field and the supervising or collaborating physician in the Supervising Provider field as applicable.  

 

MDHHS is allowing providers time to adjust incorrectly billed claims. Providers will have until March 30, 2025, to adjust paid claims and add the supervising NPI. Adjusted claims should include the claim note “Adjusting to add supervising NPI.” 

 

Starting in April 2025 until complete, MDHHS will void claims that were incorrectly paid. The impacted claims can be identified by the claim note of “MSA 20-56”.