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Upcoming NPI Requirement for All Medicaid Waiver Providers

Attached to this webpage is a notice to certified providers of waiver services through the Ohio Department of Developmental Disabilities (DODD), the Ohio Department of Aging (ODA), and providers of state plan services through the Ohio Department of Medicaid (ODM). The notice shares that there is a new requirement for which you will need to take action. Effective November 25, 2019 ODM implemented a policy under Administrative Code 5160-1-17 requiring all providers to obtain a National Provider Identifier (NPI) and keep it on file with ODM. Federal law requires that an NPI be used to identify providers on any standard transaction for health care services. Since waiver services are paid in part using federal Medicaid funds, you must obtain an NPI and update your records with ODM to include your NPI. This notice explains how to obtain an NPI, and how to report your individual NPI to ODM.

Attached to this webpage is the full written notice to certified providers of waiver services in Ohio.

You can create an account at this website to sign up for an NPI, and refer to this guide showing DODD services and suggested taxonomies (NPI service categories) or this website to review NPI taxonomies in detail.

Additional resources, including suggested taxonomies for DODD services and a guide for NPI sign up, are linked in the External Resources on the right side of this page.