Reminder: Nine-Digit ZIP Code Requirement
As a result of the National Provider Identifier (NPI) implementation, providers are encouraged to submit the complete nine-digit ZIP code for the billing provider address on claims.
Nine-digit ZIP codes entered on claims must match the nine-digit ZIP code on file with Medi-Cal or inaccurate payment of services may result.
Inclusion of the nine-digit ZIP code will help ensure that claim payments are sent to the correct provider location when more than one service location is contained in an NPI record.
To find complete zip code information, click here, or copy/paste the following URL into your browser: http://zip4.usps.com/zip4/welcome.jsp.
Having a nine-digit zip code is particularly important for providers who replaced multiple Medi-Cal provider numbers and locations with one NPI. Providers may call the Telephone Service Center (TSC) at 1-800-541-5555 to verify their nine-digit ZIP code on file with Medi-Cal.
This information is reflected on appropriate Part 2 manual replacement pages.
This also applies to Medicare/Medicaid
MLN Zip Code Article with list
Key Points of CR5970
To access a file containing the quarterly additions and deletions to the list of ZIP Codes requiring a plus four extension refer to http://www.cms.hhs.gov/prospmedicarefeesvcpmtgen/01_overview.asp on the CMS website. The file is named “ZIP Code Changes” and can be found in the Downloads section of this web page.
To access a file containing all ZIP Codes requiring a plus four extension, refer to http://www.cms.hhs.gov/prospmedicarefeesvcpmtgen/01_overview.asp on the CMS website. The file is named “ZIP Codes Requiring +4 Ext” and can be found in the Downloads section of this web page.
Upon release of a new quarterly update, the previous quarter’s additions and deletions are incorporated into the file name “ZIP Codes Requiring +4 Ext” file and are not included in the “ZIP Code Changes” file.