KMAP BULLETIN: Ordering or Referring NPI - Enrollment Type Requirements

Date: 05/28/24

Effective with dates of service on and after June 1, 2024, the
ordering or referring National Provider Identifiers (NPIs)
submitted on a claim must have an enrollment type of Individual
(I), Individual within a Group (IG), or Ordering, Referring,
Prescribing (ORP).

The following Provider Type/Provider Specialty (PT/PS) will be
exempt from this requirement:
• 06/060 - Hospice

Claims submitted with ordering or referring NPI with enrollment
types other than those mentioned above will be denied.

Note: The effective date of the policy is June 1, 2024. The
implementation of State policy by the KanCare Managed Care
Organizations (MCOs) may vary from the date noted in the
Kansas Medical Assistance Program (KMAP) bulletins. The
KanCare Open Claims Resolution Log on the KMAP Bulletins
page documents the MCO system status for policy
implementation and any associated reprocessing completion dates
once the policy is implemented.