Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 220 - Radiology
Chapter 1 - General
Rule 23-220-1.1 - Provider Enrollment Requirements
Universal Citation: MS Code of Rules 23-220-1.1
Current through September 24, 2024
A. Radiology providers must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to the following provider type specific requirements:
1. National Provider Identifier (NPI),
verification from National Plan and Provider Enumeration System
(NPPES),
2. Written confirmation
from the IRS confirming the provider's tax identification number and legal
name, and
3. Clinical Laboratory
Improvement Amendments (CLIA) certificate and completed Certification form, if
applicable.
B. Independent Diagnostic Testing Facility (IDTF) providers can only be enrolled for submission of crossover claims.
1. IDTF
providers cannot be enrolled for submission of straight Medicaid
claims.
2. A copy of the Medicare
certification from the Medicare Intermediary is required.
3. The Explanation of Medicare Benefits
(EOMB) is not acceptable.
Miss. Code Ann. § 43-13-121; 42 CFR § 455, Subpart E.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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