PACE

Provider Bulletin

May 16, 2008

Prescriber NPI

Effective Friday, May 23, 2008 PACE/PACENET, CRDP, SPBP and other programs administered by the Department of Aging will accept either the prescriber’s NPI or Pennsylvania state license number in the PRESCRIBER ID Field, number 411-DB. Either of these ID numbers, when identified with the correct prescriber ID qualifier, will be accepted when these Programs are billed either as the primary or secondary payer.

The correct Prescriber ID Qualifier must be entered in field 466-EZ.

The NPI qualifier is “01”; the Pennsylvania license number qualifier is “13”.

NOTE: Field 466-EZ is a 2 character field. The Program must receive the 2 digit “01” for the NPI qualifier; the single digit “1” will deny.

Claims submitted with an incorrect qualifier will deny with PACE Error “466”; NCPDP Error “EZ“--“MISSING/INVALID PRESCRIBER ID QUALIFIER.”

When billing PACE/PACENET, CRDP, SPBP and the other programs as the secondary payer, providers may continue to follow the primary plan’s rules. PACE will continue to accept the prescriber’s DEA, NPI or PA state license number if the correct prescriber ID qualifier is entered in field 466-EZ.

Questions may be directed to Provider Services at 1-800-835-4080.