NPI Requirement for HCBS Providers

Date: 08/26/20

This bulletin applies only to Home and Community (HCBS) Providers.

Starting October 1, 2020, for HCBS providers that have more than one NPI number, Sunflower will use the KMAP Provider Enrollment list to determine which NPI to include within each service authorization, based on provider specialty, rendering location and service type.

The KMAP enrollment file includes each provider’s tax ID and NPI number by location and service specialty type.

HCBS providers that have enrolled with more than one NPI number should refer to the KMAP enrollment to verify that the correct NPI number is included within the claim for each specialty service.

HCBS providers should ensure that each of their NPI numbers is enrolled in KMAP in the correct provider specialty for each service type they intend to and are qualified to provide.

If you have questions about this bulletin or other provider resources, please contact Customer Service at 1-877-644-4623.