Author Topic: should box 33 contain the group NPI or the individual physician NPI?  (Read 8423 times)

Michele

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Question

Hi Michele,
I work for a practice which includes 3 physicians. Each physician has their own NPI # and we have a group NPI # as well. I am confused about what information should be in box 33 of the new HCFA1500 form. Ours currently print the physicians name and the practice address. In box 33a is the group NPI # and 33b is the legacy id #. My question is should box 33 contain the group NPI or the individual physician NPI? Also should the physicians name or the group practice name be printing in this box? I appreciate any help you can provide. Thanks,
Cindy

Answer
Hi Cindy,
What information goes in box 33 of the HCFA depends upon how you wish your payments to come. If the payments should come to the group name under the group tax ID#, then the practice name and address and group NPI number would go in box 33. The individual dr's NPI number would go in box 24j to identify who actually performed the service. If you want the payments to come in each individual dr's name, then their individual information should be what goes in box 33. In other words, whatever name and NPI number are in box 33, that's who the insurance company should send the payment to. (I say should because even if you do it right, that never guarantees what the insurance company is going to do!) I hope that helps!
Michele
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Re: should box 33 contain the group NPI or the individual physician NPI?
« Reply #7 on: January 16, 2023, 01:55:29 PM »
Hi,

As per my information HCFA 1500 Claim Form box 33 contains "Billing Provider Info and Phone Number" and 33a is for Billing Provider NPI , 33b- Billing Provider Other ID Number. Please refer this link for information confirmation- [https://medicalbillingrcm.com/cms-1500-claim-form-hcfa-1500-claim-form/]Sample HCFA 1500 Claim Form[/url]
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