Medi-Cal sets February 2027 attending and referring NPI requirements for LTC claims
Oct 18, 2026 edition · GC-2026-0418 · Published 2026-10-18 · Version 1 · Final
Long-term-care providers face separate attending and referring NPI requirements from February 1, 2027. Initial, discharge and transfer claims need both; ongoing claims still need the attending NPI. Submitted identifiers must be valid individual NPIs for the billed service date.
What happened
DHCS’s October 16 notice establishes new NPI requirements for Medi-Cal long-term-care service dates on or after February 1, 2027. Claim forms, including UB-04, must include both an attending and a referring provider NPI on initial, discharge and transfer claims. An attending NPI is mandatory on every claim, including ongoing claims; the notice does not state that both NPIs are required on every ongoing claim.
The submitted attending and referring identifiers must be 10-digit, valid Type 1 individual NPIs on the National Plan and Provider Enumeration System file for the billed service date. DHCS says claims will be denied if an applicable identifier is missing, invalid, inactive, absent from that file or the wrong NPI type. The notice says revised provider-manual sections will follow in a future Medi-Cal Update; those future sections were not established by this announcement.
Scope and timing
- Authority status
- Final
- Applicability
- Operationally relevant
- Audience
- Health systems, Provider networks
- Jurisdiction
- California
- Affected functions
- Revenue Cycle, Clinical Operations
- Responsible owner
- Revenue Cycle
- Recorded date
- 2027-02-01
- Date type
- effective
Why it matters
LTC admission, discharge, transfer and ongoing billing workflows have different identifier requirements. Treating the requirement as a single generic NPI field risks both missing required data and applying unsupported edits to ongoing claims.
Recommended action
Suggested internal action: Revenue Cycle and LTC operations should map each claim type to the required NPI fields, test individual-NPI and service-date validation with the billing vendor, and track the forthcoming manual revisions before the February 1 effective date.
Implementation playbook
- Map attending/referring fields by LTC claim type and retain test cases; suggested internal preparation. Revenue Cycle
- Confirm admission, discharge and transfer handoffs capture the necessary individual identifiers; suggested internal preparation. LTC Operations
Sources
- Ordering, Referring and Prescribing: NPI Requirements for LTC ProvidersOfficial · DHCS / Medi-Cal Providers · 2026-10-16
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