Nebraska Medicaid Program

Current Initiatives

National Provider Identifier (NPI)

Nebraska Medicaid is in the process of procuring a new NPI compliant Medicaid Management Information System (MMIS) claims processing system. This system will not be implemented prior to the May 23, 2008, NPI implementation date. Consequently, Nebraska's NPI interim solution is to be able to accept the NPI, but to continue to require the legacy Medicaid provider number and other legacy identifiers, such as the Social Security Number (SSN) and state license number, in the 837 transactions in order to process claims and make payment.

Nebraska Medicaid currently accepts the NPI, but does not plan to be fully compliant until the new MMIS is installed.

You must submit your Nebraska Medicaid Billing Provider Number on all claims (electronic and paper) for processing and payment of claims. Nebraska Medicaid will notify you when we will accept only NPI.

Until the installation of an NPI compliant MMIS, only the 837I, 837P, 837D and 835 will accept or send the NPI, along with legacy identifiers. Changes to all other transactions are not planned at this time.

Paper Claims

Nebraska Medicaid is not making any changes to how you will submit Provider Identifier information on paper claim forms.  NPI is optional on CMS 1500 and CMS 1450 claim forms.  You may enter the NPI on the claim form, however, Nebraska Medicaid will continue to require the legacy Medicaid Provider Number and other legacy identifiers (SSN and state license number) to process claims and make payment.

Electronic Transactions:

If you are a provider or trading partner that submits electronic claims, the following information is to assist you.

Obtaining an NPI

Providers can obtain NPIs only from the national enumerator. Nebraska Medicaid does not assign NPI numbers to a Provider. For information about how to obtain an NPI please access: http://cms.hhs.gov/apps/npi

Testing Prior to Sending an NPI to Nebraska Medicaid

Prior to submitting an NPI each Trading Partner must complete testing with Nebraska Medicaid. We require two successful files of no more than 20 - 25 claims each. You must contact the EDI Help Desk prior to submitting NPI test files or any other test files. When you are ready to test, contact the EDI Help Desk to schedule NPI testing at medicaid.edi@dhhs.ne.gov or 1-866-498-4357.

You may review Nebraska Medicaid’s NPI Testing Plan by accessing the link below.

PDF NPI Trading Partner Testing Plan

NPI Frequently Asked Questions

PDF All forms available on this page are in PDF format and require the use of Adobe Acrobat Reader which can be downloaded for free from Adobe Acrobat Systems, Inc.