What is a UPIN Number?

What is a UPIN?
Under Section 1861(r) of the Social Security Act of 1985, the Health Care Financing Administration, HCFA, was required to establish a unique physician identifier for each physician who provides services for which payment is made under Medicare. This includes medical doctors, osteopaths, doctors of dental surgery or dental medicine, podiatry medicine, optometry and chiropractors. HCFA developed a six-place alphanumeric unique physician number, UPIN, which is issued to all physicians, whether in solo or group practice. One UPIN is assigned to a physician, regardless of the number of practice settings, that UPIN is assigned throughout the physician’s Medicare affiliation in any state.

When are UPIN’s necessary?
Medicare is now collecting the necessary data to aggregate payment and utilization information for individual physicians. This requires that the UPIN of the ordering or referring physician be shown on all Medicare Part B claim forms involving referrals, including claims from laboratories, durable medical equipment supplies, hospitals, end stage renal disease facilities, radiology and other imaging centers, physical therapy facilities and consulting physicians.

NOTICE: As of January 1, 1993, physicians are also required to provide their UPIN to any physician or facility to whom they refer a patient, any laboratories or hospital from whom they order tests, or any supplier from whom their order supplies or equipment for a medical beneficiary.

How do I obtain UPIN Information?
The UPIN directory is available through a variety of sources. You can get a UPIN listing from your local Part B Medicare carrier by calling the local Dallas Office at 972.766.7405, G
overnment Printing Office at 202-512-1800 or on the Internet at www.medicare.gov/Physician/Home.asp


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