The RPA has been granted a unique Health Care Provider Taxonomy Code or NPI number that identifies the RPA as a recognized health care provider by CMS. The code set was announced on July 1, 2008 and became fully effective on October 1, 2008.

The HCPTC listing can be found at: www.wpc-edi.com/custom_html/tax_new.htm The RPA code is found on page 6 of the document. The number in the left column is the HCPT code for the RPAs and is 243U00000X. Of special interest is that a Health Care Provider Taxonomy Code (HCPTC) was privileged only to RPAs credentialed by CBRPA, as the certification agency. In addition, the CBRPA scope of practice has been recognized as defining the field or parameters of practice. Obtaining the HCPT code for the RPAs allows the RPAs to obtain NPI numbers identifying them as a health care provider.

Other non-RPA (CBRPA) individuals attempting to use the HCPTC code will be subject to the same measures levied for fraudulent actions. The fines for an individual are $250,000 and possibly five (5) years in jail for providing fraudulent information on the NPI application.

This is a major and significant step in continuing strategy to legitimize the RPA as a mid level healthcare provider. In conjunction with the physician’s NPI number, the RPA-NPI number can be included on reimbursement forms submitted to the CMS carriers to indicate the RPA’s performance or participation in a procedure or examination. The radiologist can still be reimbursed for the full amount of the fee because the RPA does not have billing privileges and works under the supervision and direction of the physician. ( For additional clarification go to http://www.cms.hhs.gov/NationalProvIdentStand/ to find additional NPI information.)