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I realize that most of the state Medicaid Offices do not require that a rendering provider have their own individual Medicaid ID number in order to provide services at your agency.

However, the final 2011 rules from CMS require that all Eligible Professionals who want to participate in any of the EHR Incentive Programs must have an active individual Medicaid Provider ID number.

If your Eligible Professionals are lacking this number – or you’re unsure – you can follow these steps to streamline the process:

Ask each EP or call your state Medicaid contact and ask how many of your providers have their own individual Medicaid ID number. You will need their NPI number in order to do this.
Once you have established that each EP has an individual Medicaid Provider ID number, you will need to make sure that the individual Medicaid numbers are linked to your group Medicaid provider numbers. This is critical for Medicaid to be able to reconcile the Medicaid patient volume numbers each EP submits.
If an EP does not have an individual Medicaid Provider ID number, they must get one. In most states, the process for getting an individual Medicaid Provider ID number is the same for providers that want to get one in order to be able to provide services to Medicaid members.
The following states have set up a special process for providers who only want a Medicaid Provider ID number in order to participate in the MU programs. This special process is explained on these state specific pages:

  • Georgia
  • New Jersey
  • Pennsylvania

About ClinicTracker

ClinicTracker is a robust, future-proof mental health and substance abuse EHR. Dr. Michael Gordon, a renowned clinical psychologist, and Joshua Gordon, an award-winning software engineer, founded the company in 2000. ClinicTracker EHR’s powerful software empowers your agency to succeed. ClinicTracker will automate all of your clinic routines, boost staff productivity, increase billing efficiency, and provide the tools you need to manage your clinic effectively. While mental health and substance abuse agencies are the most common group of users, foster care agencies, social services, equine assisted therapy programs, university clinics, academic counseling systems, family counseling services, and eating disorder clinics also take advantage of our powerful software.