Does a clinic need to bill using different NPI numbers, depending on which provider rendered the service, or should a clinic use their own NPI number?
If each provider who renders the service bills the Medi-Cal program directly, as the billing provider their individual NPI must be reported on the claim. The clinic’s NPI must be reported in the Service Facility Location Information field on the claim. However, if the clinic obtained an NPI and uses it for billing all services rendered, then the claim will be billed using the clinic’s NPI. Since there will only be one RAD or 835 transaction issued for each NPI, it will be the clinic’s responsibility to determine the payment due to the provider who rendered the service. The individual practitioner who rendered the service will need to be identified in the “rendering” provider field by their individual (type 1) NPI.
