An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov
Version 3.27.0

SERVICING-PROV-NPI-NUM

Data Element

DE Number

COT190

System DE Number

COT.003.190

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition

The NPI of the health care professional who delivers or completes a particular medical service or non-surgical procedure. The SERVICING-PROV-NPI-NUM is required when rendering provider is different than the attending provider and state or federal regulatory requirements call for a "combined claim" (i.e., a claim that includes both facility and professional components). Examples are Medicaid clinic bills or critical access hospital claims.
Size X(10)
FLF Start Position 361
FLF Stop Position 370
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be 10 digits
2. Value must have an associated Provider Identifier Type equal to '2'
3. Conditional
4. When Type of Claim (COT.002.037) not in ('3','C','W') then value must match Provider Identifier (PRV.005.081)
5. Value must exist in the NPPES NPI data file

Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP261 CIP.003.261 SERVICING-PROV-NPI-NUM CIP00003 CLAIM-LINE-RECORD-IP
CLT213 CLT.003.213 SERVICING-PROV-NPI-NUM CLT00003 CLAIM-LINE-RECORD-LT