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Atypical

The Center for Medicare and Medicaid Services (CMS) defines atypical providers as providers that do not provide health care. Providers who may be enrolled in CHAMPS or Bridges and do not perform medical services (e.g. Home Help, Non-Emergency Medical Transportation (NEMT), Adult Foster Care (AFC)). Atypical providers may submit HIPAA transactions, but they do not meet the HIPAA definition of a health care provider and would not receive an NPI number. (1)

Domain Administrator Resources


Non-Emergency Medical Transportation (NEMT)

  • CHAMPS Enrollment Instructions -PDF
  • CHAMPS Revalidation Instructions -PDF

Local Education Agency (LEA)

  • CHAMPS Enrollment Instructions - PDF

Community Transition Services (CTS)

As outlined in the policy bulletin, MSA 21-11,  CTS Agencies will be screened and enrolled in CHAMPS.

    • Facility/Agency/Organization (FAO) Enrollment Instructions: PDF
    • Rendering/Servicing Enrollment Instructions: PDF
    • Currently enrolled atypical providers needing to add the CTS specialty can submit a modification.
      • Atypical Agency Modification Instructions- PDF
      • Atypical Individual Provider Modification Instructions- PDF

Other Atypical Provider Resources

Home Help Provider Webpage

Adult Foster Care Webpage

Community Transition Services 

 

Return to Provider Enrollment Home Page

 

(1) A health care provider is defined under HIPAA in federal regulations at 45 CFR 160.103