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Colorado Revised Statutes Title 25. Health § 25-3-118. Hospital off-campus location--obtain and use unique NPI--definitions

Current as of January 01, 2025 | Updated by Findlaw Staff

(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 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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Cite this article: FindLaw.com - Colorado Revised Statutes Title 25. Health § 25-3-118. Hospital off-campus location--obtain and use unique NPI--definitions - last updated January 01, 2025 | https://codes.findlaw.com/co/title-25-health/co-rev-st-sect-25-3-118/

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