MassHealth shared this month’s Pharmacy Facts. The ordering, referring and prescribing (ORP) referring provider national provider identifier (NPI) is not required for claims for durable medical equipment (DME) and home infusion services billed by pharmacies through the Medicaid Management Information System (MMIS). To avoid denials for claims with dates of service on and after August 1, 2025, pharmacy providers should not enter the ORP referring provider’s NPI on the claims for DME and home infusion services billed through MMIS.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.