Under a new federal rule, school-based audiologists and
speech-language pathologists must have a National Provider Identifier number or
other unique identifier to provide services to Medicaid-eligible students in
Obtaining an NPI, already required for clinicians in health
settings, is a relatively easy process. Here's what you need to know.
What is an NPI?
The NPI is a unique 10-digit identification number required
of all covered health care providers under the Health Insurance Portability and
Accountability Act. Providers, health plans and certain other organizations use
their NPIs—which replace any previous provider identification systems—in a
variety of administrative and billing transactions. NPIs will or may be
required to complete a Medicaid claim, depending on the individual state
Who needs an NPI?
School-based audiologists and SLPs must have an NPI number
or an acceptable alternative (a "unique identifier number") to complete a
Medicaid claim. Each individual state Medicaid plan decides who will need an
NPI. If the state requires NPI for school Medicaid billing, the school district
may require each audiologist or SLP to obtain an NPI. District policies may
dictate whether or not an NPI number will be required.
How do I apply for an NPI? Is there a fee?
Audiologists and SLPs can apply online or call 800-465-3203
to request an application. The process to apply for and receive an NPI is
simple, free and takes only a few minutes. Check with your school district to
determine if you should apply individually or if the district plans to collect
information and apply on behalf of all its providers.
What is the application deadline?
The actual implementation date is different from state to
state. Many states will require school-based providers to obtain an NPI in
Will this process affect my income tax obligation?
The answer depends on whether a clinician is an employee of
a district or an independent contractor. If a clinician is employed by a school
district that contracts directly with the health care agency (Medicaid), the
individual clinician's income taxes are not affected, even though the
provider's NPI may be listed on claims as the "rendering provider."
If, however, the audiologist or SLP is an independent
contractor billing Medicaid directly for services provided in the school
setting, reimbursement for those services is considered taxable income.
Where can I find more information?
ASHA, the federal government and other organizations have
several resources on NPI:
For more information on NPI or other funding issues related
to school-based practice, contact Kathy Wheat, chair of the ASHA School Finance