Ordering/Referring/Prescribing Provider Claim Requirements - Change effective May 1, 2024
Effective for dates of service May 1, 2024, and after, ND Medicaid will require that the ordering/referring/prescribing (ORP) provider’s individual National Provider Identifier (NPI) be present on all 837P transactions (professional claims) for the following services.
Behavioral Health Rehabilitative Services including:
- Behavioral Intervention
- Individual and Group Counseling
- Intensive in-home for Children
- Nursing Assessment and Evaluation
- Skills Integration
- Skills Restoration
- Audiologic Function Tests
- Diagnostic and Screening Laboratory Services
- Diagnostic and Screening Radiology and Imaging Services
- Echocardiograms
- Electrocardiograms
- Electronic Analysis or Interrogation of implanted devices
- Neurodiagnostic Services (EEG, VEP, EMG, Polysomnography)
- Pulmonary Function Studies / Testing
- Psychological and Neuro-psychological Testing
Eyeglasses frames, lenses, and contacts
Durable Medical Equipment and Supplies
Hearing Aids
Occupational Therapy Services
Physical Therapy Services
Physician Administered Drugs (any drug administered in the clinic setting)
Preventive Services including:
- Immunizations
- Preventive Evaluation and Management Services
- Well-Child visits
- Adult preventive exams
- Counseling for Risk Factor Reduction
- Tobacco Cessation
Prosthetics
Speech Therapy Services
Read the Ordering/Referring/Prescribing Providers policy to learn about which provider types may be ORPs and other requirements. The policy also contains a FAQ section.
Date of Update
Update Category
Provider Type
Provider Year
2024