Attention: All Providers Claim Edit for Rendering Provider Service Location

Rendering providers must list the addresses of all facilities where they perform services as provider service locations under their National Provider Identifiers (NPIs) in NCTracks. The system uses a combination of NPI, taxonomy code, and service location in processing claims. This edit has been in place since March 2, 2015, but has been set to “pay and report” to alert providers to update the rendering provider location on the provider record.

Effective November 1, 2016, if an address where the service was rendered is not listed in the provider record as a service location for the rendering provider's NPI, the claim will suspend with Edit 04526 and EOB 04526 –RENDERING LOCATOR CODE CANNOT BE DERIVED. This will delay the completion of claim adjudication and payment. For more information, refer to the October 2016 Medicaid Bulletin.