What’s an NPI?
The NPI (short for National Provider Identifier) is a unique identification number issued by the federal government to healthcare providers. It’s required on all HIPAA-related administrative and payment documentation, including insurance claims.
NPIs can be given to individual care providers or larger practices and organizations. You can apply for one as a solo massage therapist or, if you’ve set up an LLC or other business entity for your massage business, you can apply for one for your business. When you apply for an NPI, use a desktop or laptop. You may get an error if you try to apply for an NPI on your cellphone or mobile device.
Why should I get an NPI as a massage therapist?
The NPI is your official identifier in health-related transactions, including those reimbursed by Medicare, Medicaid, and private insurance plans. It allows you to receive payment from insurance plans when a treatment is covered by a patient’s insurance. This increasingly includes massage, as more health plans are beginning to cover it as a treatment for various conditions, from chronic pain to mental illness. Even if you do not bill directly for services, if you work with organizations that do submit HIPAA-covered claims, you may need an NPI. That includes some appointments with Zeel.
Massage therapists, as of 2007, have the option to obtain an NPI. Other healthcare providers such as doctors, dentists, and physical therapists, are also required to register for NPI numbers.
RELATED: [VIDEO] Applying for an NPI, Step by Step
What does an NPI not do?
Obtaining an NPI does not:
- Guarantee payment by a health insurer or plan
- Substitute for other licenses or credentials
- Enroll you in a health plan
What is a taxonomy code and how is it used?
You will be asked to select a taxonomy code when you apply for your NPI number. Your taxonomy code indicates to an insurance company what type of provider license you hold. Carriers will match your NPI’s taxonomy code to that of every claim billed to them.
If you are not licensed for the type of service your NPI’s taxonomy code represents, all of your claims will be denied until it is corrected with the NPPES. The taxonomy code for massage therapy is 225700000X.
How much does an NPI cost for a massage therapist?
There is no cost to apply for, or to obtain, an NPI as a massage therapist or other healthcare provider.
If I move or change areas of practice, do I need a new NPI?
No. You retain the same NPI regardless of where or by whom you’re employed. If you already have an NPI, you do not need to get another one.
Note that if you change your business or mailing address after getting an NPI, you should update it in your NPPES account.
Does an NPI number expire?
Your NPI number will never expire, and you will never need to renew it.
I am legally working in the United States but do not have a Social Security Number (SSN). Can I get a NPI?
Yes. If you are a healthcare provider legally working in the United States without an SSN, you may use your Taxpayer Identification Number (TIN).
How long does it take to get an NPI?
The issuing agency, the CMS (Centers for Medicare & Medicaid Services), estimates that a properly filed application will result in the applicant being issued an NPI in about 10 business days.
While this is the guidance the CMS provides, massage therapists who have applied for the NPI recently have reported receiving the NPI in as little as one business day. The CMS does not send an email notifying you when the NPI is issued; you can simply check for it online after you apply.
How do I apply?
Applying for an NPI online as a massage therapist is simple and only takes only about 15 minutes. Go to the NPPES website and follow the instructions provided.
To learn more about the application process, check out our step-by-step walkthrough video of the entire thing—it’s easier than you might think!
