Hospital off-campus location - obtain and use unique NPI - definitions

(1) An off-campus location of a hospital must apply for, obtain, and use on all claims for reimbursement or payment for health-care services provided at the off-campus location submitted on or after January 1, 2020, a unique NPI that is separate and distinct from the hospital's NPI. The off-campus location's unique NPI must be included on any claim for reimbursement or payment for health-care services provided at the off-campus location, regardless of whether the claim is filed or submitted by or through a central office of the hospital or a health-care clearinghouse. (2) As used in this section: (a) "Health-care clearinghouse" has the same meaning as set forth in 45 CFR 160.103. (b) "NPI" or "national provider identifier" means the standard, unique health identifier for health-care providers that is issued by the national provider system in accordance with 45 CFR 162. (c) "Off-campus location" means a facility: (I) Whose operations are directly or indirectly owned or controlled by, in whole or in part, or affiliated with a hospital, regardless of whether the operations are under the same governing body as the hospital; (II) That is located more than two hundred fifty yards from the hospital's main campus; (III) That provides services that are organizationally and functionally integrated with the hospital; and (IV) That is an outpatient facility providing preventive, diagnostic, treatment, or emergency services.