45 CFR 162.410 - Implementation specifications: Health care providers.

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There is 1 rule appearing in the Federal Register for 45 CFR 162. View below or at eCFR (GPOAccess)
§ 162.410 Implementation specifications: Health care providers.
(a) A covered entity that is a covered health care provider must:
(1) Obtain, by application if necessary, an NPI from the National Provider System (NPS) for itself or for any subpart of the covered entity that would be a covered health care provider if it were a separate legal entity. A covered entity may obtain an NPI for any other subpart that qualifies for the assignment of an NPI.
(2) Use the NPI it obtained from the NPS to identify itself on all standard transactions that it conducts where its health care provider identifier is required.
(3) Disclose its NPI, when requested, to any entity that needs the NPI to identify that covered health care provider in a standard transaction.
(4) Communicate to the NPS any changes in its required data elements in the NPS within 30 days of the change.
(5) If it uses one or more business associates to conduct standard transactions on its behalf, require its business associate(s) to use its NPI and other NPIs appropriately as required by the transactions that the business associate(s) conducts on its behalf.
(6) If it has been assigned NPIs for one or more subparts, comply with the requirements of paragraphs (a)(2) through (a)(5) of this section with respect to each of those NPIs.
(b) A health care provider that is not a covered entity may obtain, by application if necessary, an NPI from the NPS.
Effective Date Note:
At 77 FR 54719, Sept. 5, 2012, § 162.410 was amended by redesignating paragraph (b) as paragraph (c); adding a new paragraph (b), effective Nov. 5, 2012. For the convenience of the user, the added text is set forth as follows:
§ 162.410 Implementation specifications: Health care providers.
(b) An organization covered health care provider that has as a member, employs, or contracts with, an individual health care provider who is not a covered entity and is a prescriber, must require such health care provider to—
(1) Obtain an NPI from the National Plan and Provider Enumeration System (NPPES); and
(2) To the extent the prescriber writes a prescription while acting within the scope of the prescriber's relationship with the organization, disclose the NPI upon request to any entity that needs it to identify the prescriber in a standard transaction.

Title 45 published on 2013-10-01

The following are only the Rules published in the Federal Register after the published date of Title 45.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-08-04; vol. 79 # 149 - Monday, August 4, 2014
    1. 79 FR 45128 - Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Office of the Secretary
      Final rule.
      These regulations are effective on September 3, 2014.
      45 CFR Part 162

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United States Code
Statutes at Large

Title 45 published on 2013-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 45 CFR 162 after this date.

  • 2014-08-04; vol. 79 # 149 - Monday, August 4, 2014
    1. 79 FR 45128 - Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Office of the Secretary
      Final rule.
      These regulations are effective on September 3, 2014.
      45 CFR Part 162