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APDA Plans for Changing Reimbursement Including Ultrasound Transport

Important Announcement Impacting Your Portable Imaging Supplier's National Provider Identifier (NPI) and Health Plan Enrollment

Important Announcement Impacting Your Portable Imaging Supplier's National Provider Identifier (NPI) and Health Plan Enrollment

 

After two years of work the NAPXP has successfully redefined the National Provider Identifier (NPI) for “Portable X-ray Supplier”  with the goal of obtaining reimbursement for ultrasound transport and simplifying validation.  There is much work still to be done which APDA will vigorously undertake.  Please read about this opportunity below.

 

 If you previously selected “Portable X-ray Supplier” as the “area of specialization” associated with your portable x-ray or imaging operation's National Provider Identifier (NPI), then please note the following revision impacting your NPI record.

“Portable X-ray and/or Other Portable Diagnostic Imaging Supplier” has replaced “Portable X-ray Supplier” in the NPI record for your portable x-ray operation. This change could also impact your enrollment with health plans other than Medicare.

The change is effective July 5, 2016.

NAPXP initiated this revision in 2014 when it requested a change to the Health Care Provider Taxonomy—the national classification system that is used to describe the area of specialization for individual health care providers and health care entities in their NPI records, when enrolling with health plans, and in some electronic health care claim transactions with payers. The National Uniform Claim Committee (NUCC) maintains the Health Care Provider Taxonomy.

NAPXP advocated on behalf of the portable imaging industry for a new area of specialization in the Health Care Provider Taxonomy that reflects contemporary portable imaging suppliers and the full scope of services they provide.

Definition of Portable X-ray and/or Other Portable Diagnostic Imaging Supplier:

In the Health Care Provider Taxonomy (version 16.0) released on January 1, 2016, “Portable X-ray and/or Other Portable Diagnostic Imaging Supplier” is defined as:

A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed.

Source: Health Care Provider Taxonomy (version 16.0); page 190. See attached.

Note: “Portable X-ray Supplier” has been eliminated from the Health Care Provider Taxonomy and is replace by “Portable X-ray and/or Other Portable Diagnostic Imaging Supplier.” The 10-digit alphanumeric code, 335V00000X, previously associated with Portable X-ray Suppliers has been transferred to Portable X-ray and/or Other Portable Diagnostic Imaging Supplier. Therefore, there is no change in the code.

Building on its success with obtaining a new taxonomy classification for the portable imaging industry, NAPXP launched the “Taxonomy Promotion Initiative” in January 2016 to advocate for changes to federal regulations and Medicare policies that advance the new taxonomy classification such as:

Payment for the transportation of all portable diagnostic imaging equipment and technical personnel to a patient location and payment for the set-up of all portable diagnostic imaging equipment since payment for transportation and setup is now unjustifiably limited to only portable x-ray procedures.

 A single enrollment with health plans under the new taxonomy classification is possible. 

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