(1) An off-campus location of a hospital must apply for, obtain, and use on all claims for reimbursement or payment for health care services provided at the off-campus location submitted on or after January 1, 2020, a unique NPI that is separate and distinct from the hospital's NPI. The off-campus location's unique NPI must be included on any claim for reimbursement or payment for health care services provided at the off-campus location, regardless of whether the claim is filed or submitted by or through a central office of the hospital or a health care clearinghouse.
(2) As used in this section:
(a) "Health care clearinghouse" has the same meaning as set forth in 45 CFR 160.103.
(b) "NPI" or "national provider identifier" means the standard, unique health identifier for health care providers that is issued by the national provider system in accordance with 45 CFR part 162.
(c) "Off-campus location" means a facility:
(I) Whose operations are directly or indirectly owned or controlled by, in whole or in part, or affiliated with a hospital, regardless of whether the operations are under the same governing body as the hospital;
(II) That is located more than two hundred fifty yards from the hospital's main campus;
(III) That provides services that are organizationally and functionally integrated with the hospital; and
(IV) That is an outpatient facility providing preventive, diagnostic, treatment, or emergency services.
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