Reminder: Use a street address for the Billing Provider Address on Medicaid claim forms

Updated 8/24/23 to clarify between forms 1500 and 837P

Per HIPAA standard and NUCC guidance, the Billing Provider Address field on Medicaid claim forms —both paper and electronic (EDI) – must be a street address. We occasionally see Medicaid claims with a P.O. Box address in this field, which isn’t allowed.

How we’re addressing the issue

• Currently, payments for claims found to have this error will be recovered. Providers can rebill with the appropriate address information.
• In the future, we hope to implement an edit which will front-end reject claims with this error back to the provider.

What you can do

Here’s how to avoid claim adjustments due to this error by claim form type:

Claim form type	How to bill	How we'll pay
1500 (paper)	Use a physical address* in the Billing Address field (item 33).	We’ll issue payment to the remit address that’s in our system.
837P (EDI)	Use a physical address* in the Billing Address field. A P.O Box is allowed in the Pay To field.

*Don’t have a physical address? Use your servicing location.

Updating your remit address

If your remit address in our system is incorrect, you can update it in prism . Learn how.