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HIPAA Transactions and Code Sets

HIPAA Identifiers

Identifiers

Identifiers are HIPAA standards that will create a uniform and centralized way to designate an employer, provider, health plan or patient in electronic transactions. Identifiers: 

Standard Unique Health Care Provider Identifier (CMS-0045F)

    • Establishes a standard unique ID, adopting the NPI (National Provider Identifier) as the standard identifier for all health care providers under HIPAA
    • The final rule was published on 1-23-04
    • Compliance date is May 23, 2007

CLICK HERE FOR MORE ON THE NPI

Standard Unique Identifier for Employers (CMS-0047F)

    • An employer’s tax ID number or Employer Identification Number (EIN) will be used
    • The final rule was published on 5-31-02
    • Compliance date is 7-30-04 (small health plans have until 8-1-05 to comply)

Standard Unique Health Plan Identifier (CMS-4145P)

  • Establishes a standard health plan (for payers) identifier
  • The estimated notice of public record making (NPRM) is 2004

Standard Unique Identifier for Individuals (not drafted yet)

WHY DO WE NEED IDENTIFIERS?

This page was last updated February 2, 2006 and is maintained by