Which NPI is required in Block 33a of a CMS-1500 claim form?

Which NPI is required in Block 33a of a CMS-1500 claim form?

• A. Rendering provider
• B. Attending provider
• C. Billing provider
• D. Service facility

Answer: (C)

The key idea is identifying who is responsible for submitting and getting paid on the claim. Block 33a is designated for the Billing Provider’s NPI—the entity that actually bills the payer for the services rendered. This is typically the physician’s practice or clinic, or the organization that submits the claim and receives payment. The other roles have their NPIs recorded in other places on the form. The rendering provider’s NPI, who performed the service, appears in a different field, and the attending provider’s NPI is also captured separately. The service facility’s NPI relates to where the service was provided and, if the facility is the one billing, its NPI would appear in the appropriate area rather than in Block 33a. So, Block 33a must contain the Billing Provider’s NPI.

The key idea is identifying who is responsible for submitting and getting paid on the claim. Block 33a is designated for the Billing Provider’s NPI—the entity that actually bills the payer for the services rendered. This is typically the physician’s practice or clinic, or the organization that submits the claim and receives payment.

The other roles have their NPIs recorded in other places on the form. The rendering provider’s NPI, who performed the service, appears in a different field, and the attending provider’s NPI is also captured separately. The service facility’s NPI relates to where the service was provided and, if the facility is the one billing, its NPI would appear in the appropriate area rather than in Block 33a.

So, Block 33a must contain the Billing Provider’s NPI.