Other ID Qualifier
An Other ID Qualifier is a field on the CMS 1500 form that is used in the instance where you need to add another ID, if you do not use an NPI number in your work.
Note: If you have an NPI number, you can enter that in the "NPI" field and will not need to enter an "Other ID Qualifier" or "Other ID."
If you do not have an NPI number, then you need to fill out the "Other ID Qualifier" and "Other ID" fields.
"Other ID Qualifier" is used to indicate the appropriate qualifier for the Other ID listed. The qualifiers will indicate the non-NPI number being reported. The NUCC defines the following qualifiers can be used:
"0B" - State License Number
"1B" - Blue Shield Provider Number
"1C" - Medicare Provider Number
"1D" - Medicaid Provider Number
"1G" - Provider UPIN Number
"1H" - CHAMPUS Identification Number
"EI" - Employer’s Identification Number
"G2" - Provider Commercial Number
"LU" - Location Number
"N5" - Provider Plan Network Identification Number
"SY" - Social Security Number (the social security number may not be used for Medicare)
"X5" - State Industrial Accident Provider Number
"ZZ" - Provider Taxonomy